38157 77 Ni OF SAN JOSE -ff61Xih&rK
BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
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Application is hereby made-for a permit f15st�--- ------------------------------------------
-------story. .I r -------------------------------------------------- Building
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to be occupied only as 7.!
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peci at,;;n',' an rt-
- a fil "Cerewith.
in accordance with Plans, S
Estimated Value of Improvements,
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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-
any manne o as to violate the workmen's compensation laws of California
'Tzr., -VA/v e C ��4v-�Z�� /,9-
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Contractor�'Agent
Vc,m 280.1
RECORD OF INSPECTION
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