32986 CITWOF SAN�S� 9""" -BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT k3�5
Date---/W --------5�✓---------- 19--- Permit - ------
Application is hereVbmade for ep
perm' ..................----------- ------------------------------------------
a-- ----- . ............ .................. ............................ Building
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at Att
to be occupied only as
in accordance with Plans, Specifica lon f-pl116;0 Wer w671Y
Estimated Value of Improvements, /�Qzoo
_--------------------
It is hereby agreed that the requirements of the San Jose Building and Zoning Ordinances and all other
laws applicable to the construction, location, and use of buildings within the City of San Jose, will 6o
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(/1/... ---- ----- .... ----- --------------&#.,..Address �6 "I
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7-� -
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By .. ..... ---------------------Address -- --
94fractor, AgIn
Form 2M]
RECORD OF INSPECTION
Foundation ---- Frame
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