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CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT .
rmif No.----
Date........... 195--9.-,
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- -------------------- . . I
Application is hereby made for a permit to--------------------------------------------------------------------------
a-----------
/------story, Type... ivy- ---------- ----v-- ------ ------ -I-------- -- --------------------------------Building
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1*9� .5 ...... ------- ...... - --- ------ -_
at----_..------./--- ----- -------- -- ---------------------------------- ................
tobe occupied only as...i--------- ------------ --------------------------------------------------------------------------------
in accordance With Plans, Spe afiancl Plot-p)10W
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Estimated Value S. ------- -
It is .hereby agreed that the requirement$ 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, Al be com-
plied 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 manner so a, to become subject to the workmen's,compon,ation laws of California.
Owner---- I ate.l
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.._C4_4__Jnc...Acdress..... ............
Address:�...Pa19_A_1tQ:--------------- ------ -- --
--
Contractor Ynt
Farm 280-1 943BlaAnvwood Wheatley Gonst.
RECORD OF INSPECTION
Foundation------
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..............-.................... . ----------------------------------
Stucco...... ./..------
Fin
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