52879126!? -
858 Roseblossom
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT�9t�
Date 5�9 , 19&,Z Permit No.
Application is hereby made a permit to.4��
a_
at
Zone
to be occupied only as /1 / /f} Kra r ce
in accordance with Plans, Specifications and P�lot�-pl�� file ere i e nkler
Estimated Value of Improvements, $�6C)6 _•
Exemption from requirement for State of Califo is for Confracior's License is hereby claimed by undersigned:
as owner ❑ statement filed ❑ /J
Undersigned attests that his State of California Contractor's License #
is in full force and effect and properly authorizes this application.
San Jose City Business License # G/— /1— 07c—
I'certify that in the performance of the work for which this permit is issued I shall not employ any person
in any manner so as to vio }e the workmen's compensation laws of California. ^
Owner C
By - Address la sac
49V-Ro o Som 9 John Cecile �� _
99/5 - WOI - I-O8Z .,0j
C 2Acz
N01103dSNI d0 Gt1003a
856 Hose Elessom
CITY OF SAN JOSE BUILDING DEPARTMENT
///---.`.J____ APPLICATION FQR, BUILDING PERMIT sow'
Date------ ................19(,' Permit No ----------------------------------- -----
is hereby made for a permit to .......................
r. TVDe_ '
at ---------- 4:,�--.1.(i
to be occupied only
in accordance with Plans, Specifications and Plot -plan filed herewith.
Estimated Value of Improvements, $..../yQ
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 r"nner so es to become, subject to th�kmen's co p nsation law of California.
1.90
A,
Owner.
Address......-----....A!4c-----------------------------.....----
Contractor, Agent
Form 111.1858 Rose Blossom Z,lr4G Loma verde
RECORD OF INSPECTION
Foundation ... ........--1 -1�--/ ...............Frame-._�.......................
.
Stucco... f LJ'Co-a u(ypdsc"_
- — —.... .Finish...... - r----------- -------..................................
'=�?-iT-Go