437901210 Staffford \
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract No .... .3..$1. ...... Lot No._84..................
Date .............................. .3110............. 19----. 4. Permit No... &2..✓..Qt
4................
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Application is hereby made for a permit to ....... ........on.st........ruct............. ...............................
....
a .............1 --story, Type ----- V------------�_//./�il�__iiA_/�........---------n.... Building
1210 Stword Drive Use Zone ... R.l,�.i.......
to be occupied only as .--..51 ugic �" " ��/ --
' •---- � Parkin ace ....... 2........
in accordance with Plans, Specificati l!a8�blot-plan filed herewith.
�:,.
Estimated Value of Improvements, $ ......................................... � �_���
It is hereby agreed that the requirements of the San Jose Building and Zoning rdinences an ell at er lews
applicable to the construction, location, and use of buildings within the City of San Jose, will be complied with.
I certify that in the performance of the work for which this permit is issued I shell not employ any person in
any manner so as to violate the workmen's compensation laws of California.
Brookfield Corp. 3150 -20th Ave., S.ii..
Owner.................................................................... Address.----------------------------..........--...............
Contracrill�iaM
neon s�uction
By Agent .. "' v% . `""'.".............AddressP.&• --- BOX...
13.1.p..5a11...�ru110
A. Plant
RECORD OF INSPECTION
Stueeo..... -.............
-------------.......... ................ v-. Finish..:?.:cr.�..:
Form 280-1-10M-12.63