32364 (2) 8�)q Rose blossom
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION F05 .LUILDING PERMIT
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Date...--....... I 7��q. Permit No..177 .1---4.¢..........
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Application is hereby me
_ e for Prmit.fo---. ... .... ............................................
----------- -----story, Type. .. ... . . ........ ... .........................
Building
at------------------------- ............................
........ W_ 40.1t11tF In......
to be occupied only a,-----/-'--
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, ��Q
-- --------- ---
It is hereby agreed that the requirements of Ae 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 manner so as to become subject to the workman's compensation laws of California.
Owner...
W.4VZ...&;kZddress----------------------------------------------------------------
By------------- - 7 -------Address..................................................................
Form �i�9 Contractor, Agent Loma Verde const.Blossom
RECORD OF INSPECTIOm
Foundation........
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