33291 CI461OF SAN JOSE 116t�1�7 BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date.......MaV..6z............................. 19...... Permit No.....3... ;n-ti-........
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Application is -y me--- raPd�C,.
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............................................ Buildinga-SiI7P7Es}orY
at .....lQ-.3-Q-1-........4....
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to be occupied only ��peci�fieca,;
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in accordance with`J� / � r ferewi+h.
Estimated Value of Improvements, $-III--1-Q/-0 0-Q----/-----
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 manner so as to violate the workmen's compensation laws of California.
Owner1Jheatley_ C onstr :. 0A_99,-Address -----4U2.11-Camino-May.................
By ....Address ---_Palo Alt°
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Con ctor, Aganf
Form 280-1 _ _
,(R�'E�CpORD OF INSPECTION
Foundation S`=.�r. ..�st�....1�/...Z�fr�Lt�.G'Y... Frame G�7I(s.. -------- ..
Stuc o Finish 'P�72( -LPc)....!
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