193 (2) 943 Rose Blossom
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
DateC�Z�� 19 Permit No.
Application.is hereb made for a permit fo
a_��ory, T pe . _ uJddiing/ Use Zone
at E /(/Occupancy
to be occupied only. as �M �� Parking Space
in accordance with Plans, Specifications andP t file wry, inkler
Estimated Value of Improvements, s. 9 ... - Elect.
-
I certify that in the performance of the work for which this permit is issued I shall not employ any person
in any manner so as to violate the workman's compensation laws of California.
Owner M� �c�'TNEP Address �� ,2.rs¢ �les'sor/�2 Sf
Bya%ou6 Address !8S`DOUGL yrE rc, S✓,
RECORD OF INSPECTION
Foundation Frame
Stucco Oy Finish
---—260=601'.
943 Rose Blossom
Exemption from requirement for State of California for Contractor's License is hereby claimed by applicant:
as owner ❑ statement filed k
Applicant attests that his State of California Contractor's License #
is in full force and effect and properly authorises this application.
San Jose City Business License #
zav, ryr�eZ� f'r" ydr
280-601 N