42420K
S
aTY0F SAN J0PennBUILDING DEPARTMENT
APPLICATION FOR BU ILDING PERMIT
Tract No.�� Lot No��Y ------------
Date... --------- ................. . 19-Z Permit No. V --------
Application is her"ejor a permif,�,
4V7 ......................... .......
a.... ' I---- story, Type
-------------------- Building
at .. .... ... .. ... Use Zone
-------- - -
Occupancy ....... . �z ......
c
to be occupied only as. . . . . . --------- -------- Par 4k1,0n;,,;"SPa ce -----------
in accordance with Plans, Specifications and Plof-plan filed herewith.
Estimated Value of Improvements,
It is hereby agreed that the requirements of the ' S" ---Jose 7 '*'*---
Building and Zoning Ordinances and .11 other
laws applicable to the construction, location, and use of buildings within the City of San Jose, will be
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 manna so as to violate the workmen's compensation laws of California.
0
0
YA
Form
` RECORD OF INSPECTION J
Foundation :--�.d.---��.-``_y_ Frame
Stucco ------ --------- ------------------------- --------- --------- V- rmish - .-.�.'Si-7.... .t..� k.=-------'-