8176,850 M)SMFOOK NE x
Tract No.
CITY OF SAN JOSE
Date r 6- Y .
Application is hereby:
a / story Type
at G
to be occupied only as
in accordance with Plans,
Estimated Value of Imps
1 celtify \that in the
in any manner so as to
By
Lot No.
BUILDING DEPARTMENT
CATION FOR BUILDING
19 Permit No
for a permit to
PI
Address
Address
t*04( Use Occupancy
Sq. feet
filed herewith. Parking Space
Fire Sprinkler
mer. Elect.
V er�hall not employ any person
i
This permit shall expire and become null and void if the work authorized by it is not commenced within
120 days from the date issued or if the work is suspended or abandoned for a period of 120 days after
commencement.
FINAL INSPECTION
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•uoltmoldde $lgi sezuogine AlAodoAd pue loeye
,� I •ory esueol� s,iotoenuo� 1 0 0 93e3$ 5!4 ie 1
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:lueolidde Aq pewlelo Ageieq n esue31-1 s,jolaequo:po; elwo;lle3;oelelS Jo; 3uewennba (
) Nor ueS
Imo; Iln; ul si
tueopddy
Aumo se
PM ( -. I 'SPECIFY
• 8. APPROVED • ( 19: REMARKS:
DISAPPROVED ( �)
3.
A 7. INSPT. MADE
TIME
• WHITE - FILE YELLOW- INSPECTOR PINK- OFFICE
1. LOC • O�
L
2. DATE
4 READY AM (
ANYTIME
1
'5. TYPE OF
6. A
PM ( -. I 'SPECIFY
• 8. APPROVED • ( 19: REMARKS:
DISAPPROVED ( �)
3.
A 7. INSPT. MADE
TIME
• WHITE - FILE YELLOW- INSPECTOR PINK- OFFICE