33291 6379 Ath6i+W66d
CITY OF SAN JOSE tot 1�d BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERM IT
Date------- ............................ 19.... Permit No.------3..3-4----/-------
Application is hereby made for a permit to ---construe-t-------------------------------------------
a---single.sfory,Arpl a ----/--
--- -- --- ------------------------- --------- Building
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at -Z4 Z>.-
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to be occupied only as ...�in f arn tTy
—gle---------- ..dwelling
in accordance w PI n, i ca onl
,gS Spec�:i fi d P1 f 1, n filej' herewifh.
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It is hereby agreed at the requirements of f e San Building and Zoning Ordinances and all other
OW
Estimated V
San 'a
laws applicable to the construction, location, and use . 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 workman's compensation laws of California.
Owner ......Wheatle.v...Constanicti-on-Qu.Address ---------4 ll2-Jl--.C-aMin0..T)9AY------------
By
Address ---------FA1.0-Al-t-0---------------------------------
C tractor, Age
_I
form 280-1
RECORD OF INSPECTION
Founda+ion
--------- ------ -------------------------------------- Finish
"W%co ------- --- ------------------------�a3y 6