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CITY OF SAN JOSE Ps.4,r K ei 8 BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date..../V a v- 10!....................... 19....... Permit No.---.-3...�L'92- 7
Application is hereby made for a permit to ------ -----------------------------------------------
a......!..........story, TYpe--=z-- - ------- - ------- - -------- ---- --- � ----------------------- Building
of .7_y 'a3 ....... .
to be occupied only as ---1.------L"A.h!�j.:-
in accordance with Plans, Specifications and`Plot-plan filed herewith.
Estimated Value of Improvements, $--/-.0-_Q-o-o----------------
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 Joie, will be
complied with.
I certify that in the perfofminae of the work for which this permit is issued I shall not employ any per-
son in any manner ss as to violate the workmen's compensation laws of California.
Owner RI �'`.w Arr o.Src....Address ......14
......
B !/� 'Jac `eft c._� ---.Address ..S!9.--- aO r'e - ------................
y _ f-..
Contractor, Agent
Form 280-1 -
RECORD OF INSPECTION
-.z7- ,6,,--
Foundafion �� �j'� G O �Cs�Frame --/--------_�---
S4ucco --------------------------------------------------------- . Finish ..
Elect 55203 1-25-61
PLbg 39627 11-28-60
Gas 54620 11-28-60 3_ 27