804840 Rose Bloss_rh
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FO Q ILDING PERMIT go yt-
Date.....-----/ Y�.............:._19€/.0.. Permit No..--'--....-'--.............---.......-
Appli/ca#ion is hereby ma for a permit to ` ..
a----------- -story, Type---- - F_/_-
- = -- '-- ----- ---- ------- ------- ----------------Building
to be occupied only
in accordance with Plans, Specifications and Plot -plan filed herewith.
Estimated Value of Improvements, $....1.. ✓....�....`�
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 certify ASk in the performance of the work for which this permit is issued I shall not employ any per.
son in anyar so as io�b%e Mme subja } }o a work n's compensation laws of yCalifornia.
Owner_ ---.... - -- `-LC..�-- -----4 - ddrers.. sL1Ml�- <�(p
�/.1—YIA - - - A AJK
Contractor, Agent
Form zeo.I 840 Rose Blossom 2�/Y,Ld soma Verde
RECORD OF INSPECTION
Foun�d6tion_ -.- 1 _'z=�................. Frame......-.-- �^ 6 D
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Stucco_--......------------------------------- ......... . ... .-----Finish....... ............
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