38786 (3) 7653 Peach Blossom Drive
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Z Permit No_o- ...Q. -----------' --.
Date.................. b?
Application is hereby made for a permit to ------------CDNST ucT......................................
a......n-----'--stor Type �" :' 's�2.....`��" s :' �` '...................... Buildin
Y, Yp ..... --- 9
-!- --
at ..1.sY4:�---
-.-'-- -�.---.--- �r .`COT :- � 3 RiNGA� :#5 TRAQ 2017
to be occupied only as SIAJ.SEE-F,4gmY-R�E�EMCE
in accordance with Plans, Specifications /and Plot-plan filed herewith.
Estimated Value of Improvements, $/�..®0 ................. 7 9i Q
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
complied 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 manner so as to violate the workri�en's compensation laws of California.'
MT . ? i L, 1i"t 3"CIO �1 Ca,-::
Owner -----'----------------.....;'---......-----......- Address ._..........-'------ a--:-1n4 Real........--..
Menta Park, Calia; ia
By $:--J:- urgean ---.Address -. -
- - fi :ofsnperz 1=7WO----------------
Form 280-1 Cop"RE't Afk'a(lager
RECORD OF INSPECTION
Foundation • .. .. ................................. .... :_ Fromm�..�r...�`�.............2,11 O'l --
Stucco ---------------------------_ /------�;
.--------------------------------- Finish .........c-
Z