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CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract No. 2-57,3,� Lot No. —�7....
Date ............. 3-7�� ----- Z=;7 ........... lqer-,.�—No.S q
Permit ------------------------------------
-
Application is hereby mad I r a per it t 44L------------ ------- -- -................. --------------
a --- story, Typr-1,�,;�- /i-Z -- ----------------------------- Building
—4 Use Zone ./I_.-......_---
+ a--- /.11�7.20 ...... ----- ---- -- Occupancy ......11� ----------
----- ---- -- ------
to be occupied only as ------- --- ------ S ace ---------- 77?:=-
----------- -- i pha t7NF
in .accordance with Plans, S a i ication, n P6plan r � iWL- 1�-
Estirnafed Value of Improve n - -- ------ ---........
------ --- .... .
It 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 performance of the work for which this permit is issued I shall not employ any per
son in any manner so as to violate the workmen's compensation I ws of California.
------------- Address ..........................
Owner - ---------------- --------------------
Contracter'
ByAg.nt ....... --- --------Address -
Form 286-1'1070 Colony Hills Dr. W.H.
RECORD OF INSPECTION
Foundation -- ------ - --
It ti:l 7�- Frame ... ....... �S--/A
Stucco -----------------------
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