NO PERMIT NUMBER (2) 884 dose Blossom
CITY OF SAN JOSE j/ei, as .6 BUILDING DEPARTMENT
APPLICATION FSR B ILDING PERMIT
Date---... APPLICATION
-------------------- CPR
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Application is hereby made f it permit to-- —------------------------------------------------
a-----------/-----story, Type-- --- .......................Building
at------------------ --- --- -- ....................:.......
to be occupied only as......./.r --- ---- ----- . 1. ..........17 V-5
r ;-*W- --,, /- ----------------
in accordance with Plans, Specifications and Plof-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
as to be 0sulaie to f wor men's compensation laws of California.
son in any man"r so
Owner- .A(
ddress-- T
By-------------( Address..... --- ---------------a
---------- -------------------- ................
Form 260-1 Contractor, Agent Loma V
884 Rose Blossom 2�lp,66 erde
RECORD OF INSPECTION
Foundation...-2. 2-;6 — /— — 3 2,)4— C--d
................................ .........Frame.......... ....................................................
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