NO PERMIT NUMBER -Lily Ave.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR, BUILDING PERMIT 3
Date---------- :-----------------196& Z:!F:;z Permit No-------------------------------_--------
Application is hereby made for a permit to.---e- v..I----------------------------------------------
story, Type- -- ----- -------------------------------------------------------------Building
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t U00
----- .... .
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to be occupied only as..... . . ... .
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, $-/,! .4-0.....
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.
, certify that in the performance of the work for which this permit is issued I shall not employ any per-
son in any ener so as to, be me su6jo t to the%torkrnen's compensation laws of California.
Owner_ 46A0dress-
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BY-------------- --------- - -- -- ----------Address----------------------------------
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Contractor. Agent
Form "" 885 Lily Loma Verde
RECORD OF INSPECTION
......... .................Frarne'.I.I=A�
Stucco....................................................................Finish_.........
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