457527481 Plum Bloss) m
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract No ..... 3701 .......... Lot No ........ 64 .............. PLAN 36 0
Date ...... DE. - .-..�-.jg&4...::............ 19---------... Permit No.:�.�.. -.2.—......-----
Application is hereby made for a permit to
a ........ ?........ story, Type ......... V..R DEnEE w/aT_ Ai
7481 PLUM BLOSSOM DRIVE
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I................._......................Bwldin
Use Zone..... R-1
Occupancy ..... I...
to be occupied Only as ...�..�AM ILY REST DEN F4APp kin4jc Fpce!....2 ................
in accordance with Plans, Specifications and Ploof-plan file�d/h�erewi+Hvv�
Estimated Value of Improvements, $...25.000
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 person in
any manner so as to violate the workmen's compensation laws of California.
Owner ..........:-- .. ............. ................... Address..BGkit!L.TF.i..C.AMP..D .V....CO.....
COn+raCtO 2633 SO. BASCOM
By Agent....( �� -A�G Addre55......._�MPBEL CALIFORNIA------__---
RECORD OF INSPECTION
Form 200-I—IOM-1263