33276 77,86 'Ribb' 4e 6
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Dat - , Permit No.S.5---21_77fa-----
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4(ication is hereby made fpr a permit fo%--- ------------------------------------------------
a!!--------/......fort', Type--- ----- -------- ---------- ---------------------- Building
at ---------- - ---------------
to be occupied only as ---- ------ ------------
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in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, ------ -------
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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
complied with.
i I certify that in the performance of the work for which This permit is issued I shall not employ any per-
son man so as-to violate the workman's compensation laws of C If
i any
....Addresz<�516
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7�
y -.Address --/------
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A
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Form 280-1 7f8rM8brAJ
de11 AUnter
RECORD OF INSPECTION
Foundation Lz,-
Frame --------------------------------------------------------------------
Stucco ....-----------------
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Elect 52063 5-20-60
Plb& 37286 5-12-60
Gas 52367 5-12-60