34759 8056t dni4661
C1 O SAN OSE Lot 128 BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT ;
Date------Jung__;!Q---------------------------- 19_6.4...... Permit No._F/-.7s
Application is hereby made for a permit to --construct
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stor , Type -_- Building
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to 6o occupied only as _singl ....family--dwelling
in 'accordance with Plans, Specific vofhe
Plot•pla filed hhere .
Estimated Value of Improvements,,
It is hereby agreed that the requirementsan JoseBuilding 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.
Owner ---Address -4112...E1--Camino-.-Y,iay------------.......
BY --------------Address Palo- A-Lto-------------------------------------
--- ontractor, nt .
Form 280-1
RECORD OF INSPECTION
Foundation ......... Frame
st,40 ------------------------------------------------------------- Finish
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