43212 (2) CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDINy PERMIT
'7 -
Tract No. Lot No._ ,
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Date. /................................ I -- ------- Permit No..43212n...--------
Application is hereb , ade for a r it f ------------- ............................... .......... ..
a.. /.......story, Ty --A
L I—. ..5./...----..------------.... * Building
at .17 ... ... - --------
Use Zone �--f.
490ancy ........
Z72
to be occupied only as/./-— ----- ------ - --- XAW&e�l ------4..............
in accordance with Plans, Specifications and Plot-plan filed ewith.
. i_
Estimated Value of Improvements, $__11 5
7_.
3 �e...............
If is hereby agreed that the requirements of the Son 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 per ormance of the work for which this permit is issued I shall not employ any per
son in en oner sQ,aoo �iolafe the workmen's compensation laws of. ... .. ColhfForni �-
ddres/ .....
. .............. A
Con"
...............Address
Form 280.1
RECORD OF INSPECTION
Foundation Frame //
Stucco --- ---------- ............... .....-.................. Finish