NO PERMIT NUMBER (2)843 Betlin
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date ........... `% ' 17/ 195 v/ D Permit No ....... -....... ------ -- - --
Appl/pli ion is hereby made for ayerpermyiitt tom---ry�v ---------------------------------------- -------------
a-------`--- ------ sfory, TYPe.- ..... 11!! �n'1. ................-........Building
to be occupied only as -----,/--- Z=..! .... ✓ ....n..rry-.--'.....�----------.....---
in accordance with Plans, Specifications/ and Plot -plan filed herewith.
Estimated Value of Improvements, .-.1-- 6700
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.
Contractor, Agent
Form 280-1
RECORD OF INSPECTION
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