36160 yZ7L MULILL-I(Jre
CITY OF SAN JOSE Zo PZ4 /./ st- BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date......s,/z --------------------------- 19_61-- Permit No.
Ap/plication is hereby
C!made for a permit to --Zl '------------------------------------ ----------------.
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to be occupied only as .-.. .....f ... .._-. ,L—�(�
in accordance with Plans, Spe iK�tZ 6 n ot- dr✓�ilgtl'herewith.
Estimated Value of Improvements, $_-111,0W------------------
It is hereby agreed that the requirements of the San Jose Building and Zoning Ordinances and all that
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 sous to violate the workmen's compensation laws of California.
--------Address
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Contractor, Agent
Form 2BO-1
RECORD OF INSPECTION
Found 'Z
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