37039 (2) 7744 Carr'li
,96 C A-
CITY ,& SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
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Date... ......
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Application is he f a, permit to
......7 -------- -----------_-- Building
a
----------- ----story, e---- . ... . .. ......
to be occupied only as /,-.;;�
in accordance with Plans, Specifications and Plot4n.Jiled herewith.
Estimated Value of Improvements, $.._L
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It is hereby agreed that the requirements of the-Sen 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-
son in any manner sc, as to violate the workman's
By C compensation/laws
ompensationXlaws f Carnia.ia.
. /......Addressn _7 -----e 7�
.... . ...Address - 7 ......... ............
Contractor, 'Agent
Form
280-1
RECORD OF INSPECTION
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