35686 (3) BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
z.....
Date..... --------------------------------------• 19.41—.
Permit No.-------}._ .. -.....-..-------- -- -
Application is hereby made for a permit
rmit to ---------------------------------------- -
-
-Building
.5... ' -----------------------------------------------------------
.......-'t------story, Type--..--9......
at ...
. ......
a
to be occupied only as ---- ...
with.
in accordance with Plans, Speci i" n4 .A a,
Estimated Value of Improvements. $........
nt, of the San jose Bu in g and Zoning Ordinan c,s and all other
It is hereby agreed that the requireme. an j.sa, will be
lawspappjicable to the construction. locati n, and use of building, within the City Of S ploy any per-
com tied with. of the work for which this permit is issued I shall not a
I certify that in the performance
son in any manner so as to violate the workman's compensation laws of California.
..............
0y ..............y. ...Address.
Owner
7�
...........................
Address ------
Cp�ractcr, Agent
Form 280-1