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CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
LOT.......13.4......SFRINGARDEN #4 TlgrrnTF— 121
Date.... MAR-24-M-1----------- 19------------ Permit No..3 4
---------------
Application is hereby made f permit to -------CONSTRUCT-------------------------------------------
. -& , 11-12
-- --- -100,410-04------------------------ Building
a......1---------story, Type..--------------VAES; 1'1� - -----
at ...1-4-20---Primro5-e---Wa Y.................
to be occupied only as SING-L-E-F-AM-ILY--R-E.SIDENCE
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, $------ 2)----------
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 pe rformance 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 laws of California.
Owner ----------Clalld T I1300 El* Camino Real
�ROFY,jn;.....................Address ----Mk-nla-Park,--Catiftyrraa-------------- -
r, P. O. BOX 697
By Zcr '. �cldress ----- ------------------------
MeiTlo Park; iiornia
Agent
form 280-1
RECORD OF INSPECTION
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