NO PERMIT NUMBER Rote B1ogt6m
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT 8`01"
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Date.. ------ Ij.................. Permit Me-----------------------------------------
Application is hereby me for a permit to----- -a-----------/------story, Type.. .... . -- - - ------------------------------Building
a------------------- - -- - ------- ...... ... ... 61"P0(-_A7Af.............--------
to be occupied only as-------t""
--- -- -"---/-1/'.." --
------- ----- ---A...................
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 certify that in the performance of the work for which this permit is issued I shall not employ any per-
son in any nner so a�/foecomo sub'ject -to theworkmenlsscom t' I Of Califor
penF, ion aws
e cor.0, fd% 4�t..AIA
s. 7 Z"v7a-2
Owner-
By---------------- ...........Address.....---- .....14----------------------- -----------4.0-----
Form 280.1 Contractor, Agent Loma Verde
850 Rose Blossom -�-/ P- (' C
/ CORD OF INSPECTION
Fo afion--_//T�/v`/�� J7 Z/C'- .6 O-Ct-GJ�'
Stucco................................... .........................-`r'""".......... 1-G r ...-
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