38046 OF SAN JOSV�ia i BUILDING DEPARTMENT
APPLICATION FOR PERMIT
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� 19....._, Permit No.... t--O--Qs�.�------------
Ap///plication is. hereb ado or a permitta�.."......�._----------------------------------_--------
a-------f ------story, Ty P --------- . -----------------" 13&----------------------_----- Building
et .-�~....�v...l-.D.-.. .""- -- ------ - "-- ---
to be occupied only as/ c _
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in accordance with Plans, Specificati s PIK✓ a i
/ O
Estimated Value of Improvements, $ -.,1..-5. ------------------......
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 bo
complied with.
I certify that in the performance of the work for which this permit is issued I shall not'employ any per-
nn r
er-
nner so as to v�i lata the workman: compensation laws o Ca i rnial.
OCv I: . - ✓�GC.�-l-a✓!/(_-v` e.....Address/�J--G-' --------
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.......----- ---�re---- -----------------------Address�ant
Form 280-I
RECORD OF INSPECTION
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found ee-
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