12579A
i -I
LA
CITY OF SA4iJOSEra6k Lot 115 -
BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date - TSay -k' 19--60---- Permit No - ---..
Application is hereby made for a permit to -- _Construct
a. single - -- story, Typ - xES- A-------------------°--------------- --- °------ ------ --- ------ -- - - -. Building
at ----- 8.12.......
- -/
to be occupied o as ..- single----- _.- . - - -_y- dr e n
in accordance with Plan Specifications and Plot -plan filed herewith.
Estimated Value of Im ve $ -.Z -
If is hereby agreed t e r emants9 Adiun? i onincJ Ordinances and all other
laws applicable to the canstrucfi , location, and use gs i+hi n }ha City of San Jose, will be
complied wish.
I certify that in the performance of the work for which this permit is issued I shall not employ any per-
son in any manner so as to violate the workmen's compensation laws of California.
Owner heat ley. -- C oristru tion Co. Address - - - - -- -4112 �1 Camino Wip r
-
- -zy� P
BY - - - -- Address - -- -- - -_alo Alto
C rector, Age
Form 280 -I
811 Alderbrook Inane
Building Permit Confirmed ❑
J Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and /or GAS PIPING PERMIT
/Z'- lf-
Da +e...----`- °- ---- -------- -- -- -_- ._.°. -- - - -- 197-t. Permit No. ------ 1-��--� /
The undersigned hereb makes application to the Plumbing Inspector of the City of San Jose
fora permit to install p in {' ur / pipes listed an The reverse side.
Exempti9n from r uira n o if is rrir cfor' # nse is hereby claimed
by undersigned: s wnar s em d❑ Zx�(z 7 cs 6
Undersi ned attests that his ate .. of California C ct s c s 3
is in full force end affecT d properly auihoiirez fhis'appice }ion. /
•- San Jose City Businoss 'cense
I certify that in the p rme The work r it h, er it ued I shall no} employ
eny parson in any manna s as }a }he 's o
�13ffa n i ws elifarnia.
OWNER �pp 0 Al /
ADDRESS C 41-P&W 131L60/( Lni Lot No.
USE 0i:. BUILDING 12E S
280- 30(9.73) Signed
/e/
811 Alderbrook Dane. AcV _
i -I
LA
CITY OF SA4iJOSEra6k Lot 115 -
BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date - TSay -k' 19--60---- Permit No - ---..
Application is hereby made for a permit to -- _Construct
a. single - -- story, Typ - xES- A-------------------°--------------- --- °------ ------ --- ------ -- - - -. Building
at ----- 8.12.......
- -/
to be occupied o as ..- single----- _.- . - - -_y- dr e n
in accordance with Plan Specifications and Plot -plan filed herewith.
Estimated Value of Im ve $ -.Z -
If is hereby agreed t e r emants9 Adiun? i onincJ Ordinances and all other
laws applicable to the canstrucfi , location, and use gs i+hi n }ha City of San Jose, will be
complied wish.
I certify that in the performance of the work for which this permit is issued I shall not employ any per-
son in any manner so as to violate the workmen's compensation laws of California.
Owner heat ley. -- C oristru tion Co. Address - - - - -- -4112 �1 Camino Wip r
-
- -zy� P
BY - - - -- Address - -- -- - -_alo Alto
C rector, Age
Form 280 -I
I
u
•
9)
FIXTURES
NO.
FEE
MAIN DRAIN
Water Heaters
/,O0
size Material
Water Closets
r. -,,.n,
To I Fee
Bath Tubs
RAIN WATER DRAINAGE I
Showers
Size
Material
Lavatories
To
Fee i
Kitchen Sinks
WATER SYSTEM
Dish Washer
Size Material
Waste Disposals
IWater Fixture Fee
Wash Trays
HOUSE GAS PIPING
Washing Machines
No. Lines Outlets
Water Treat. Equip.
Size Fee {
Sinks
FEES
Dental Units
Fixture Fees
/,do---!
Drinking Fountains
Main Drain Fees
_
Floor Drains
Storm Drain Fees
Hoppers
Water Sys. Fee
Sand Traps
Gas Piping Fee
Urinals
Survey
Area Drains
Permit Fee
�2_oo
Water Leaders
TOTAL FEE
3.0o i
Trailer Space
INS PE TOR'S REPORT
Swim Pool
Gas Piping
Indirect Wastes
Approved
Drywall
B
Backflow Preventer
Partial
Survey
Approved
B
Rough
TOTAL
/
/,ao
Approved
B
Finish
Approved f
B
RECORD OF INSPECTION
Foundation 5'/7- �
_.. ...
-
.... r - ..
Frame G" 2 %-�G
/J
,. /o..�.�
r. -,,.n,
3 %