04319 F 7647 Elderwood C�
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT'/
Date u LN 19 T T Permit No.
Application is hereby made for a permit to g(l i I D P o 0 ,
a story,Type Use Zone
at 7 6 4-( E l N l Ll Occupancy
to be occupied only as I>v�. h n h s Sq. feet
' in accordance with Plans,Specificatio a d Plot- la filed he with. Parking Space
Estimated Value of Improvements, $ � �" Fire Sprinkler
/ Emer. Elect.
I certify that in the performance of the work for which this permit is issued I shall not employ any person
in any manner so as to violate the workmen's compensation laws of California.
Owner ]AJ i•D fC Nsa 6i2i o7 A Address 164 -1 1= L.11L.RW NOD L'Y.
By A >A LIAF T--, 0 N L S Address 7 L 8 0 �!� ttt Hi �`� •
This permit shall expire and become null and void if the work authorized by it is not 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 260.601 N
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• 1.LOCATI • O/ 2. DATE D. 3.TIME RCD.
• 4.READY - AM ( 1 ANYTIME (�i 5.TYPE OF ;1�.AREA 7. INSPT.MADE
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S 8.APPROVED 9.REMAR
DISAPPROVED ( 1
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oil-
INSPECTOR ♦4A�^r
280-671
WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE