36262 BUILDING DEPARTMENT
APPLICATION 9,R 81.LILDING PERMIT
e 22
Date----- ----------------------6/1 A------- 194,l._. Permit No. ...
Application is hereby made for a permit to --- --------------------------
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: -
-------/-� ------story, Type... -- � -------------- Building
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to be occupied only as ----------------------
in accordance with Plans, Specifications and Plot.plan filed herewith.
Estimated Value of Improvements. $...Z-Z--0-O--P----------
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-
er ' y a;g'.r so as to violateth
an - workmen' compensation laws of California.Califo
son in, y a wor2en compensation If 2 117,
Own'001--l"------ ---------- W---------------- - ------------- --- --- ----
Own
--- -
By ------------- ---------------------------------------------------------Address -- ----- -------------------------------------r-------------------
Form 280-1 105SOVE:�!`H'901ntl Euge- e D-! La Cruz
'RECORD OF INSPECTION
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