NO PERMIT NUMBER (2) 866 Rose Blossom
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT 91 -�-
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Date----- J� 7—-------------------- 19 EJ.. r Permit No.........................................
Application is hereby made or a permit fol-EMee--------------------------------------------------
-------sfor Type-- - - .: .. . .- --- --
-------------------------- ------Building
-------9-3,64-------I - ---- -------- --- -------- --- -- -- -- - ----- .........................
to be occupied only as.-.... ---- -- --------- -- . --- -- -- ....1 - ------------------------
in accordance with Plans, Specifications and Plot-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.
, certify that in the performance of the work for which this permit is issued I shall not employ any per-
son in an�y �nnar.'so as to ecome sub'ject to the wo kman's Com ensation laws of Cajifornia,,
....Add -------- -
Ow dressress---
By---------------4 *—IWV?00-y�................Address_.... ..----------_---------------------- ----- ----- ----
Contractor, Agent
Form 280-1 666 nose Blossom Loma Verde
RECORD OF INSPECTIONF-
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