66576 884 Rose Blossom Drive
Tract No.. .7 Lot No.
CITY OF SAN JOSE BUILDING DEPARTfMFgNT
APPLICATIONFOR UILDING PERMIT K
Date— — / 19 ) Permit
Application is hereby ma f r a arm' to 7
a story, Typ Use Zone
at _ �- O cu ancy
K_3 ca i ace
to be occupied only asprinkler
in accordance with Plans, Specifications and Plot-plan filed herewit
mer. Elect.
$
Estimated Value of Improvements, _�L(�Q • c/���
I certify that in the performance of the work for which this permit issued I shall not employ any person
in any manner so as to violate 4he workman's compensation laws of-California.
Owner 4 ooq AddressC� OA
By O �SgoVAddy ress /O7314C,r—At/
pr REC'O,R/D OF INSPECTION
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