33108 Liiac Wad
CITY SAN SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PUILDING PERMIT
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Daf a...... ............................. 19_j�W!it / / Permit No.3--------------------------------6
Application is hereby made for a permit to ---- ----------------------------------------------
a-------'---/--.story, Type
5- -------------------------- ----.................................. Building
at
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to be occupied only as ...f.......R.'n.
in accordance with Plans, Specificatiq,0SdCfiof4raWl/edAawKl1�1
Estimated Value of Improvements. $----A- .Q--------------
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 be
complied with.
I certify that in the performance of the work for which this permit is issued I shall not employ any per-
sonin any t 'olate the workman's compensation laws of California.
Owne
Address
...Address ----- -me.t4,bfi-----------
By
Cactor. A "t
Form 280.1 77 ,112C Way y_ iSGQ
RECORD OF INSPECTION
Foundation
.. ............
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Stucco --------------------------------------------------------------- Finish
3 2 2 j-,9
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