18192 1553r 2'�--� Lot No. -20
CITY OF SAN JOSE BUILDING DEPARTMENT
�
P.c. ate APPLICATION FOR BUILDING PERMIT
Date , 19 - Permit No.
Application Is hereby made for a permit to
a ' story,Type Building Use Zone
at , ,-1 = Occupancy
to be occupied only as �- Sq.feet
In accordance with Plans,Specifications and Plot-plan filed herewith. Parking Space
,TEstimated Value of I proveplenA,$I� �/>co Fire Sprinkler
G( � �( bC,$L GtiC/tk�/-Emer.Elect.
1 e that In the performtnco itrh)yvprk' for whichpp_r
la mit baueAl shall not employ any person
Owner " Addrm :S'� ^�, A_01/
By . .! Addrars r- /
This /�enit shall expire and become null and void if the work authorized by it isnot commenced within
120 days from the data Issued or if the work is suspended or abandoned for a period of 120 days after
commencement.
FINAL INSPECTION 280-60T78
80801/7 8
Rev. t5
' Exemption fromrequinsmentfor State of Cal lfomiafor l;ontractors.
license Is hereby claimed by applicant:
asowner❑ statementfiledy ��'/
Applicantattests that his State of California Contractors license No. - — "T Y
Is in full forceand effect and properly authalzes this aaplicatlon.
San lose City Business license No. � ^{`(1— /6. 9/D
i
1.LOCATION . •, .Z 1 �' 2{DATE
rRCD.,( 3:TIME RC,Dr'
R DY .AM ( .., ,F ANYTIME ( 1 5:TYPE OF, �6 REA 7..INSPT.MADE
PM.I �I SPECIFY, INSPECT. TIME
DATE
' 8.APPROVED, 1 ' 9.REMARKS:
DISAPPROVED
INSPECTOR
X280-671
WHITE'-FILE YELLOW-INSPECTOR PINK-OFFICE -
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