43919 (2) 908 Roseblossom
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract No.---------............Lot No.----....................
Date....`? ....................... 19-------.... Permit No.-4.11iq...................
Application is hereby made fo permit to kno.,4 ig- FiA C D
..........
........................ Building
....story. Type ...... . ... ....... .
f JE, Use Zone....L-1.............
U
se
------Z..............
to be occupied only AWp ip��ce....2--------------
..Y��of-;aK-dled Irerewith.
in accordance with Plans, Specifications an
Estimated Value of improvements, $...Z.2-ap------- ........LL �o
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 permit is issued I shall not employ any person in
any manner so as to violate the workmen's compensation ,aws of California.
Owner..;L� j... ............................Address.s. .L....................................-------------
Contractor.
By Agent ........
John Cavalli
908 aer2-st-%%VUg- I
RECORD OF INSPECTION
Foundation.............................•----
stucco— .../ o c:...-rlm:h ....- .... ................... - ........... -
S�wae �.cuc 1
Form 280-1—IOM-12-63