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CITOF SAN JOSE 9 BUILDING DEPARTMENT(
APPLICATION FOR BUILDING PERMIT
Tract Nie?'---�;' 9. Lot a
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Date...511�---......_............ 19. ._.. ! Permit No. -- 0--e9 ,3
Application is hereby a for a permit . ..
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a......./....story, Typ .:. _... = Building
Use
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Zone ......................
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to be occupied only4/./....------ ------ � �/ ace ----------------------
in accordance with Plans, Specifications and Plo+-plan filed he
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Estimated Value of Improvements, $.(>/S.`..O............. .......
It is hereby agreed that the requirements of the San Jose Building and Zoning Ordinances and ell 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 s all not employ any per
son in any manrfr so ay to Viol the workmen's compensation laws of Celiforni
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LGH �......�.�. Addrest� �.�0. .../ ........... ....... . ....
Ciantract0 v`=iYS�R '/�7�'' Address /_�/... -=-..----------------------
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Form 280-1
RECORD OF INSPECTION
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