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13528
APPLICANT: . BEAR DOWN. CARBON COPY MUST BE LEGIBLE. � desi�aenq�s m�r H P,c,nyo�,ry/� DO NpT WRITE IN SHADED AREAS. . �� ^���� � �/ /'^" CHECK HERE IF YOU NEED A C�PY P•c.�Eg�!n ' �� . 6>' q OR THIS APPLICATION IN AODITION $ �y"Y � (�1'}_1-��+�k ,F .�:,Sa � yx �wN gt'�sH�. �}�. TO YOUR VERMIT ANb RECEIPT ❑ sEh,iK.F¢e fs��. �`"�'"�"�"�'"�'^'�'��`T'� �����"� M �"' ��-� PERMIT REq'D UNDER FLOOD CON- � ,�.� TROI DIST. ORD. 59�1 pHRM�pk6f!'}I - � '� � � � SHIBBFRC�KQRMACHIN�VA0.1AAT19N� ��_^ / CYGM �(� y �:{ q { q q �yr� ❑veS ❑uo S� � N�'�"4�"t�lyf �. � J � � � �d 0.!_�� s�� -�� �J'«�' hl .-�.,,«��+.uu . In ronformtty with tha pmviilons o! Secfon ]031.5 of Iha 6usineae and P�e(e cions � . E#CEPTIBNS AS NO„j�E6 ,,,,,,,,, , � Code a d Seclion 38�0 aF Ihe La6or Code of tha SIa1e of Colifomia, appli<ont� holl �toc+..lNSP. � ���` .��4� fil¢wilh Iha 6oilding Inspetior tha certificules, doslanoled�i �I� and (2� below andJer � hall 'ndicnte item �3�, �4�, �51 or �A) whi<hever is nPGcoble, i I�f Cerliflcate of Consenl of Self.lnsured issued 6Y the Otrector of InJvstrial Ralalions. pqyg IZ) Certiiicale �or exacl dvplimte coryYl of Workmen's Compensotion Insowna Issued hy an ndmitted Insorer. � O �91 The ws� aF �he work to be performed is $100 or less. 'q�A1:TH.RgnT: �' ' ' ' ' �� � " ' � � ' � ' � .eY ' � '�'� � �.i� I cenily thet in fhap erformanca oi Ilie work lor whlch this permil is hsued �ha� 1 sholl na1 omploy any pareon in any mo er so as to become zubjen � m the Warkmen's Lompansmion Lawz af Cplifornia. ,pAY� ; �5� I <¢rrify thol Ihe eppllmnr is limnsed ondar ihe pmvisiona of Chapter 9 � , �commencinq � Secran ]000) of division 3 of ihv Bosiness ond Pm{eysions Code,and mid oPplimni's Cul lorma Sfote CoNmctoi s llcensa - -� � � - . ' �E •BE,yRM�(GE6. - /,,w�• � J' ' ' ' 6V ' : No ���� flozs f calion s n l�II (orce and effecl. �(�����,. ( ��/"1"'�i,�+�� . ! !—"-1 �6� Applicant e axempf from (5� obovo under the apphmble pmvlslons Of '�'^"' ��` ��"Y �'-` . � I,,,_I Section J040 through 7059 of�he Conbadors Licrnsa law. �Stma basis ior �� T exemplion.� � �� � NaPLIcwNY'S � NIMB EP. .���rt ���� . ek�t#�+�-� » 61cNATUaE - - � f,���:..g�..a'r'C'���'f �''"� 9 ADoqEss � �(r(� � �y b�� ��' ��Pfi`�s".(� • � �""':�� , �.:. �% �I{ i C4MPRN�ATION CErtTIPICAYk VERIFI i ' �^ ' ' .�. � ... . ^^^�"+""""•+^+^i. , p1p MdR�HAI.� . " �.�¢Y THIS APPUCATION IS A &UILDING PERMiT WHEN PROPER4Y FILLEp dUT, SIGNED, AN� MACHINE VAUDA7ED IN, THE SPACE PROVIpEp. • �onr - PERMISSION IS THEREFORE GRANTED TO DO 1'HE WORK INDICATED FRUC7[C}'�. I.EN[7�kt. ,. . BELOW IN ACCORDANCE WITH ALL APPLICABLE pRDINANCES, LAWS ,. .... . _ . - � AND REGULATIONS. � - :NAME: .�_._.,,,.,,,-...,__ �„_.,,,,�,,,,,,,,,,,,,�,,,,,: � a � r � A4oHeS9: . ,,,,;. ,. .. .. _._._ _ _._ . . ,, ' '..UNICNDW.N:. . .. . L`Lf .,.... . ... .. _ .. . _ . ......... . .. . . . . - tJ�{ 9 +C���, , � ..• ��APPI,ICANi n��i�glg nlM7,�,A��V � . . INSPECTION RECQRD 41 � `y�' �._�...._ Q C7W oATE INSPECTOR pEMAftI<5 PhINP OR 1YVE.Ikl.t 2nJ'CQ4Y 1$Y�U(i6 APPLICATIOW FOR BUI6DING P�RIvfIT � FOUNOATIONPOpMS _ '�� � 2. F�RMS � � ' COUNTY OF SANTA CLARA , ppURNOCONCRETEUNTILTNEABOVEHASBEEN51GNE0 BUIL�INC. INSPELiION DIVISION '""' 20 WEST HEDDIN6 ST. • SAN )OSE,'CpqF. 95170 •. TELEPNONE 499-k351 ' 3, HEATIrvc.oucls y ' LOCATION 9, COMFOpTC�OLING LOT � BLOCN TNACT S.GIq6ER5 srqecr e qo�oq'�9essy �{ � �O NO7 COVER FLOQRS UN71L THG A@OVE HAS BEEN SIGNED � N���`"� O"1_1_J—_ ��✓ P. OON[)BEAME (CONC. BLHI � 1Y� ROU PL , �^/'�.�/ �� y^ I� . 'l. PRfiT1AL . /...CI..(IL,_�(,�/l ROt10H PLUO. POST OFi�IClE1I�c1}T�Y��. CpMPLETE (...,�/ I- /J,�� O.SEWGR INSPECT. ��I pWNLfi e PHONE �� • � / n p� Y.GAB PRE56UH� ��� w^^ ROUGH INCLUO�NGROOF. AObRE55p QTY �O. FRAME�FLVESqNO51OING C �� G M Gr/Br 7 N DONOTWIREUNT[LTHEABOVENASOEENSIGN£D AHCH TECT ' � PNONE ' ' �R 41,ROIIGH ELECTf11C W IRINO ENOINEER � corv/rn^ncran/� uc. rvo. GOVHR NO WALLS VNTlL THE ABOVE HAS BEEN SIGNEO L - Q '` � �ll � � a fz.srucco wspe e�n•N U6¢OF SYFIICTURE �/� ./ �� s- 13. PLUMeINGFINRL�pI%Tupes� _ L /V 844 ' iAPNT� � .BIP.G 6� DL+�'126AR ��I�� � . . �4.GAS aPP41PNCE3 � anCtt6 -. .yr„-r . �.�+„ y-�r.n+ 't'— _..._..._.. , i AE� IS. ELECTRICq1.FINALIFINT11P6F� � []F.%ChYATE TYPEOFIMPROVEMENY GRAOE WELL �N.PECT�ON ❑BUlLO ❑AEMD�EL�00 TD Q�EPI.IR ❑NOy¢ BCONYERY e OLMOLI6H �6. VLAN.�£PT, A.S.A. " SqKT. �///"1�- N Oi � NO.OF '/ II.pPERMAReNALT.Lo. 91ZE. �`�..f � �6YORIC6 FAMRIE3 � . llTH6R STRUC`TURQ' „ �- -- � -- - -' � - 19. CLEpRANCE qEqU1PEO ^�v � 19. BUIIOING GOMPLETE � ..«...,..,_ . . BAMZP�S �NC� @{ftTIGYANkflRHMfT �.V ��.�w.�� NOl1TILITIESWILLBECLEPRE�UNTIL"9UILpINQCOMPLETE"HA58EENS�GNED b��+ �IBTRICT 'IR64' V . . L T � 24 [:EW[R�VO __ __ H2ALJH OEPT. 21. SEPTICTANH ND. 37 E . ] 9 rL