36270 (2) 662 §te'�hAi
CITY OF SAN JOS E7 BUILD DE RTMENT
r
,z/ APPLICA ION FOR BUILDING RI
ILDIN V
4*11�1
Date------------- /z__ Permit ........ .
Application is hereby macle,for 9� permit to .... _._---------------------------------
a.....--
-------------------------------------
Rp11
a...._ --/-------story, Type----- -- -- ------- --- - --- ... . .... .. --- -- ------- Building
at ----------------- -----------
to be occupied ------- - - -----
in accordance with Plans, Specifications and Plot-plan filed Kerewith.
Estimate,d Value of improvements, ........
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-
son in any fjohMrsWohq%j ,ale fhe workmen's compensation laws of California.
2151 St. Francis Drive
Owner, _C - --------_.......Address -------------------------------------------------------------
aja---------
....... ...-
By e� ----------------.,Address ----------------------------------------------------------------
Contractor, Agent
Form 280-1
RECORD OF INSPECTION
Fo,3,datiA, L ,k4.. .../Frame ----- ....�0----------------- -----------------
Stucco ------------------------------------------------ ------- Fini,h ------------------------ POP-61 A*P-
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