12232 b 861 Bette'
6 .1.75 Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date , 19BJP ermit No. 77 Lr
A p ication is hereb mage fora permit to 1 to 1
a story,Tye r ildin� Use Zone
at T Occupancy
to be occupied o / Sq.feet
in accordance with Plans,S ecifications and Plot- filed herewith. Parking Space
Estimated Value of lrvproverWnts, $ Fire Sprinkler
er. Elect.
I certify that in th)pe or a of the w r isi t is permitu I shall not employ any person
Owner r Address ¢�
By ' Address
This permit shall expir 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.
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1. LOCATION 2.DATE RCD. 3.TIME RCD.
4.READY AMAot
ANYTIME ( 1 5.TYPE OF 6.AREA 7. INSPT.MADE
O - PM ( 1 SPECIFY I PCT. TIME
DATE
S.APPROVED 1 9.REMARKS:
"DISAPPROVED f -)
• - c • INSPECTOR
260 671
WHITE-FILE 'YELLOW-INSPECTOR PINK-OFFICE
, ® 1.LOCA9
TION - ' 2..DATE RCD. '' 3.TIME RCD.
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. 4.READY AM 1 ANYTIME ( 1 1 5.TYPE OF 6.AREA 7. INSPT.MADE
PM ( I SPECIFY_ I SPECT. TIME
DATE r
• B.APPROVED1 `. 1 9 EMARKS: i
DISAPPROVED
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• INSPECTOR G
280-671
WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE
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1.LOCATI ON �` / �1- � GIS 2.DATE RCD. 3.TIME RCD.
o/ 2 7F
III • 4.READY AM 1 1 ANYTIME ( 1 5.TYPE OF' 6.AREA 1 7. INSPT.MADE
PM .1I SPECIFYINSP-EC]'. 9 TIME
DATE�
•
B.APPROVED ( 1 9.REMARKS: /
- DISAPPROVED (�1
II •
If
As PEE r5e," 1-01A
® - INSPECTOR C fA
280-671
WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE