28609 (2) 0 SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
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Tract No. ---I—L-of No. �X�.........
Date..............:......._..1...3._...... ......--, l9a Permit No.-_3-S-6-0.1-----------_-
Application is --
hertbygac, er "o-------
------- ----------------- -----------
r4..w ---------------- - -------- Building
Use Zone ...... -Z.......
at Occupancy ........-r---------
to be occupied only as7.Z0.. ...
YN --7----Parking Space ------- --------
herewith.
in accordance with Plans, Specification and Plot-plan file
Estimated Value of improvements, $. j_40-0-P........ ....
It is hereby agreed that the requirements of fhd/S.n ;ose. Building and Zoning Ordinances and all other
laws 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 shall not employ any per
son in any manner so as to violate the workmen's'compensation laws of California.
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Contractor
Address ------
ByAgent - ----------------------------- .......... !------ -sn'.
Form 280-1
RECORD OF INSPECTION
Foundation ---- -- ... am
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Stucco ._...-._---....-..--------...---------........... Finish
........ Fin]sh
U T L i T