41862 (2) 6377 Blackwood
CITY OF SAN JOSE � I BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract, No- -------------------- Lot No- ---- ---------------
Date................................... Permit No..__4-/--n--2.......
Application is hereby made for a permit to ........ -- --------- -- -- --- - ----- -----
a----------------stery, T
-------- Building
Use Zone - -------------------
at ...._6. Occupancy --------------------
5
to be occupied only as. P4'rig Space ......................
c,
in accordance w ns cat io
Estimated Value of Improvements, $.------
It is hereby agreed that the requirements of the Son Jose Building and Zoning Ordinances and all other
laws applicable to the constrbction, 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 shall not employ any per-
son in any manner so as to violate the workmen's compensation laws of California.
Owner I —------Address 6.?
C ...................Adclres'1�4_/,_-)
Fn,m 290.1 6/8 7 Blackwood Pert
RECORD OF INSPECTION
Foundation ---_.-
------------- ..... Frame ...............----
Stucco --------- ------------------------ ------------------------..... Finish
Y
3„TI,. v�s��
FEB 14
ISE@ $ 71967