26935 802 Rose Blossom
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FQR , BUILDING PERMIT d'°3
Date--------- 1........--------.._I .(}- Permit No...-.-...
Application is hereby made for a ermi to....{ ......................................................
i
a--------- -----story, TYPe._ -- ---........--------------------'-------.-.Building
at----------- C2.Z�-/ a�ct.2! - - - ------ -------- . ....
to be occupied only as..../...z4-..',.4/�:-.. .. .- -- ...........................
in accordance with Plans, Specifications nd - an filed herewith.
Estimated Value of Improvements, 5. -�
I+ 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 com-
plied with.
i
I certify that in the performance of the work for which this permit is issued I shall not employ any per-
son in any m or so as to b onneess bjacpt to thew kmen's commpeensation laws of C iforni
Owner... R.7 uC` L�(1l.Address..iF7. f
By--- t -- ..Address..................... - - - -- ...
Contractor, Agent ,
k,m tB0-1802 Rose Blossom Loma Verde
�. RECORD OF INSPECTION
Fou ion .....................................' ' kame...N.-/f. ....................•
Stucco-----------------------------------..._----•-------------..Finish--- ----------------- --------..-.-....---- - -- - -
J6 0,/v
L I l D—j
802 ROSE BLOSSOM DR
Building Permit Confirmed ❑
Not Required Cl
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING C�RMIT
Dafe------ _/ .................. A�. - Permif'No.._a.6? 3.3...... ........
The undersigned h ab sa g ♦ m nsPec4or of {he CifY of Sen Josa
for a permit 1 instal f /o i s the reverse side.
Esempfion from requirem f for Staie o California for Contractor's License ' her by claimed
by undersigned: as owner ❑ Fart/ T' filed -?2
Undersigned attests that his 54e#e of C r on#r9f1 u / 'j�
is in full force and effect and properly au{ r' e ' f4 a` n i
San Jose City Business License
I certify that in the performance of the work for which this permit is issued I shall not employ
any person in any manner zo }o.vio ate the workmen's compensa#ion laws of California.
OWNER
ADDRESS °'
USE OF BUILDING
280-30(9-73) Signed... - – — -- ...� .. ... . �- G'
802 ROSE -BLOSSOM DR ACES"J S� xp
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