33291CIT OF SAN %JS rook Lot 10 - BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date - - - -Ma ...6- ig ... 6D..... Permit No.----- -3--- - �---- -1.1--- -----
Application is hereby made fora permi+ +o ------ construgt ------------------------------------------
aSinglo--- sfor/T)pB..!�•r,.. -e x%^12'+ a +.. --- - -- - ��.' 1------------- --- ----------- ------ ----- - ----- Building
at --a-O`-_?- --- - -- - - - - -v -"�'
to be occupied only as ----- Singgle - -- family dwelling
in accordance with Pla , Specifica +ions and Plof -p�l/a`n filed herewith.
Estimated y aged Im�ro faR Xlh7n
It is hereby agreed #h t!! r /'f" /fireman f a .lose B oning Ordina nces and all other
laws applicable to the c siruction, loca #ion, and use of buildings he 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 so as to violate the workmen's compensation laws of California.
Owner - Wheatley --- Gonstz:u 19n._i.9..- -..Address ..... 4 112 ._El- Camino-_Way-- -- ------------
/ /- -- -....- .Address . -- --------------------------------------- lto
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Co actor, Agen+
Form 280 -I - -
RECORD OF INSPECTION
Foundation
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