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CITY OF SAN JOSE ' kz-14 , BUILDING DEPARTMENT
APPLICATION FOR BUILDING, PERMIT
Date........ .................._, 19- 7 Permit
Q ................
Application is hereby made for a permit to... . G!L . .
a----------/.....story, Type- ------------------------ .e. Building
at............_...................... .........................................
......
to be occupied only.as--- _ ............. ...........
in accordance with ;Plans, Specifications �7 t-plan i er'aJ/if �
Estimated Value of 'Iriiprovements, $.._�?
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 be com-
plied 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 become subject
to the workmen's compensation llaawssof California. /��
F--4-Address.)/. �f�(r.g` -'•." !.:I`....
a 4
By.... .............Address........................o-------------------------------------
Contractor, Agent
Irm 'gi1 Grimm ? , '.'2 2,M•l Loma Verde
RECORD OF INSPECTION
pp
Foundation--------.Q..-'S. . ---—------------Frame::!.....
Stucco-------------------------------------------------------------- Finish........
............... ................................
C . y7 9iT
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