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CITY OF SAN JOSE ' Iff_166 BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date---------Dec.enher--9... ----------- 19-.5Q..... - Permit
Application is hereby made for a' permit to---------qqqs.t.ruq.t...........................................
... ...... ..
a...single---story T ... ... I - I — / Building
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at.....----635L_.BlZ
to be occupied only as---:..Sin9_1e..Fami3,v.....Dwel I ing........................................................
in accordance with Plan Spe if i cafion�sa P1..1$-pn file rAW, h
�'Pe
Estimated Valuero a ts,
ro a fS
the iremonts
It is hereby a, I the q..r., 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 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...Yhe
ati-ey..C-matructioxi--C _Address----4112..El---CaminQ..Way------------------
By------------------- ............................... ..................Address----Fal.0..Ll-t-0,,---Calif a- ---- - -----------
Contractor, Agent
Form 280-1
6354 Blackwood Wheatley
RECORD OF INSPECT19N
r ............. ......
Foundation--1 2��...... ...... '52.1.....�Fe-------
................ ...................................................Finish..Y.-xl.:m�A...........
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36-01p,003
5-0 393