NO PERMIT NUMBER SSS Rose 8166s6m
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION
Q� FOR, BUILDING PERMIT 803
Date........../ -------------------ILEI—� Permit No..........................................
Application is hereby made f a permit .. r�............ ...................................
a---------"/---.story, Type ---- _ . -- ---- . -_-----------------Building
at..... ...... �-----�------ .. -- -- -- ..., cam.-.------------------------
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o
to be occupied only as..../ .... (-----. -------- i--v-vjC .............
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, $...
It 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 er so as to becyme subjecttothe wo�r men's compensation laws offC liforn e.
AI P0
Owner..�///4 rdGv.GLtTG*6tt�.r`ddrers.O.: , GGfiGl��s[
...........
Address--------- ----------- -----..__---------..........N..
Contractor, Agent
Form 280.1 828 Rose Blossom I (n0 Loma verde
RECORD OF INSPECTION
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Stucco....................... -- "" -
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