9665 7532 keath&wood
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT��
Date le",- ,&per�mit
Permit No. PE"
Application is hereby made toa � story,T pe uil ' / Use Zone / /
at �� Occupancyto be occupied only as -�"�+ Sq,feet _
in accordance with Plans,Specifications�n�PI Ian fil h e II P Space
Estimated Value of Improvements,$ P /V ler --
Enver. ect.
I certify that in the performance of the work for which this permit is issued I shall not employ any person
in any manners as to violate the workmen's compensation laws of California.
Owner Address
By / Address �t d?�/'7 S 44Z
This permit sh& 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, rJ,
FINAL INSPECTION "'"��"'h /.L, 260601 N
Exemption from requirement for State of California for Contractors License is hereby claimed by applicant;
as owner ❑ statement filed ❑
Applicant a tests that his State of California Contractor's License No.
is in full force and effect and properly authorrii,es this application. p
San Jose City Business License No.
• O AT 2.DATE Cp, ?n 3.T E CD.
4.READY AM ( f ANYTIME I 1 S.TYPE OF 6.AREA 7. INSPT.MADE(�-
• PM ( 1 SPECIFY APE TIME Z J
DATE
• &APPROVED ( 1 9.REMARKS:
DISAPPROVED ( I
•
• INSPECT
280.6]1
WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE
• 1. OCJdTION RyCD �2'TIME RC
• 4.READY M ( 1 ANYTIME ( 5.TYPE OF 6.A EA 7. INSPT.MADE 2$'
PM ( 1 SPECT Y /INSPECT. e-) TIMEc�
DATE -PC
•
B.APPROVED ( 9.REMARKS: -
DISAPPROVED "lam eell,00,
•
i
• INSPECTOR /JCP.S
/ 280-671
WHITE-FILE YELLOW-INSPECTOR PINK-OFFIC v