33291C14'OF SAN �SE I Lot 130 BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date .... IV.. 6i . ..............................1 19 ... E?Q.... Permit No... ...7.. r. ...1.........
Application is hereby made for a permit to ......construct
a si le...atorY, T
.. ........................................ :.............................. Building
at
L s_/
to be occupied only as: .. . VA r7 Msvj
in accordance with Plans, Specifications erndd Plot -plan filed herewith.
Es +iMete
Id Velu of Im rove /1p /pots, ../..� /}-- .......y..�...........
I} rpPersby tfLthat }hq�Qjfui a rtgF tJ(gr4ep Building and Zoning Ordinances and all other
laws a Ilcabl {`R,a nor M (yr6 rQi�/ Idi n gs r within the CI} of San Jose, will be
complied wit .
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 TM.! 11.9X.. wnSf? ? � Qn/Co.ti....Address ....! ................
By ..Address ..... Pai o..Alto
Form 2
RECORD OF INSPECTION
Foundation J.Yr::AV ---- N
Stucco--------------------------------------- ------------------ -------
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