77540 F 7689 Peach Blossom
Tract No. -2 � L Lot No.
CITY•OF SAN JOSE BUILDING 6EPARTM5NT
APPLICATION FOR BUILDING PERMIT
Date— 19 eQ 4 No.-7
Appl a}ion is hereby made for a er i to
a s#or Type Blijl'dir>� Use ne
a} SSO Occupancy
#o be occupied only as ../�I—'v Fire S Space `=
in accordance with Plans, Specification n -plan filed herewi- th. Fire Sprinkler
G Emer. Elect.
Estimated Value of Improvements, $ _
I certify that in the performance of the work for which this permit is issued I shall not employ any person
in any m r as to 'olat workmen' c pensation law of California.
Owner Address By Address
RECORD OF INSPECTION
Foundation o— v G `Lf -7 Frame
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h�
Stucco
Finish �8
7689 Peach Blossom Robert Smith
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