37797C1106 ITY OF SAN JOSE �'01'aji�� J BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date. .------- ---------- -------- - -r 19. -/ Permit No. - .3.7..J�1..L..-- ---- ---- ----
Application is hereby m de for a permit fd ---.: ��....`-------------------------------------------- - - - - --
a.-- -- ..... ..story, Typ - - -P°s -- -- ----------- ----------- -- ---- ---- ------ ------------ Building
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at
to be occupied only aV T -`C �A7
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- 41C;
in accordance with Plans, Specifications and plan r i
Estimated Value of Improvements, D -
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 certify that in the performance of the work for which this permit is issued I shall not employ any per-
son in any mann so es o violate the workmen's compensation laws of Califo -e. ] „ Z u�
Own.Address /(�
-ti Address _._ -
BY .... -'- --
' Contract Agent
Form 280.1 - -
RECORD OF INSPECTION
Fountftmn - -(j
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