32067 (2) 7421- TiPtod
CITY OF SAN JOSE - 1-o T- 1 (o 77L 7-3-L 0 BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date..✓ ------------------------------- ff.... Permit .............
Application is hereby made for a permit,to., .....................................................
a....OW–E-------story, Type..... - --------0---------------------....Building
71.-P,ra-e.... .............................................................
to be occupied only as-- -----0-h -IF..................... - -- --------teWOOV6 –
– " - ---- -..k-----------------
in accordance with Plans, Speci5cafions and Plot-�Plan filed herewith.
Estimated Value of.Improvements, ---------
It is hereby agreed that the requirements of the San Josi 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 com-
plied with.
, certify that in the performance of the work for which this permit is issued I shall not employ any per-
son in any manner so as to become subject to the workmen's compensation laws of California.
Owner–tV
.... ....... -- ---- -
ByAr —-------------Address------------------------------------------------------------------
Contractor, Agent
Form 280.1 7121 Tiptoe Newman & Vierra.
RECORD OF INSPECTION
Foundation......... ..........Fr
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Stucco--------------.......................................... sh.... .... ....................
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