43418 ' 1�0� B�Lknep ,
CITY OF SAN JOSE , � � BUILDING DEPARTMENT
, APPLICATION FOR BUILDING PERMIT 3 �I A
Troe+ No. 32�1 �'
- ..._-- Lo+ No. ..__._...........
I� - _--- . /j p
Date.....12.-�7..- - - .... --- � 19..b3.. - Permit No.--`1".�-��b . ....:
Applice#ion is hereby made for a permit fo ....___C'Ori9tT'UCb : _ __.. .....
a ...---�' --s#ory� Ty ... ..�E"'�{' � /�� ...---- ..... Buildi�9
.. . ... ,. . . n
' Q
e+ ..12Q2::Belk a" -C u'r.C.-----...:...__ use Zone'.../C 1 U.--
� Occupanry _-.--
- ..:.
esidance
to be occupied only as --- .....-.-_........ . ....... P rki Spece .__.z-.__......
in accordance wi#h e , p ifica#io e 4 e fi��r i#h.
p o�
Estima#ed Velue of Improvemen#s, f...1..(.�U�......................
I} is hereby agreed fhaf the requirements of the Sen Joze Building and Zoning Ordinences end all ofher
laws appliceble to }he cons}ruction, locetion, end �se of buildings within the City of Sen Jose, will be
complied wi+h.
' I certify the} in fhe perfcrmence of the work for which this permi} is issued I shall not omploy eny per
son in any manner so es io violefe fhe workmen's compansetion laws of Celifcrnia.
'� Owner � .�.... ,..-_ , ----... --- .Addrezs .P.�...�,....Box_l�l.a........ .......
ca��a � 4 � �' � San Bruno
By�v.�,SWilliam__A:nsP�anttlSu ....Address .-- --� -... - .... - - -
t.
'� " Fol,m 280-I ,. , .. . . '
. RECORD OF INSPECTION
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