32364 841 Rose Slot6014
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
----------------- 19 p Permit Noj�2..51�v....Crl..............
Date.............
hereby M!J* for a permit ...
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Application /hZb to ......*.........
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a........../---story, Type ...... 44,4:��.......Building
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to be occupied only as...../... .. ... . ......lop
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements,
It is hereby agreed that the requirements of tv. 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.
certify that in the performance of the work for which this permit is issued I shall not employ any per-
son laws of California.
son in any me or so as to b7oc b* t to the workman's compensation
�o so lec
Owner
,�,e�.44ddclross---------------------------------------.........................
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ner.... . .. .... .
By......- . .. .. .....
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%1 !.irej,;�_�Address ....
Contractor, Agent
Form 2 1
%,1, Rose Blossom- Loma Verde
RECORD OF INSPECTION
Foundation--/.2—.=-714..-62P. -.....Fr e---3 e
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S>et-o---------------------------------------------------------------------Finish..4-7:57-4eo.... ------------
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