35938 ITY OF SAN JOSE BUILDING DE�MRTMENT
APPLICATION FOR BUILDING PERM IT7a-,-)f
No.--21579xf-----------------
Date--- .......... 19.....(0--- �ermitApplication is here6y ma for, a ermit to — ��-------------------------------------------
a--'---/-------.story, Type-7- _-- -
- -- ----------------- -------- Building
at -------------------
to be occupied only as ---- ---- ------------ -----------
in accordance with Plans, Specifications//and Plof-plan filed herewith.
Estimated Value of Improvements, $...-1.- ---=
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.
Tfc"Rerr o
son in any ws fololate the workman's compensation laws of California.
mes nc.
Owner lfr-a-nciS Drive... ......................Address ..----------------------------------- ------------------------ -
0, Cal 1r.n i.a
By 7 ------ ----- ------Address ----------------------------------------------------------------
Contractor, Agan✓
(�D
Form 280-1 -
RECORD OF INSPECTION
' [Frame .....
Foundation -C
---G-------------- ------------
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Stucco