17280 1011 IZ2Y1MO'1:_ Court
Tract No. - /) 2 I Lot No.
CITY OF SAN JOSE BUILDING DEPAItTMENT
(e IS 7y P.C.Date
APPLICATION FOR BUILDING PERMIT kyb
Date by made or� Permit No.
Application is hereby made for a pe mrt to i-rein
a sto ,Type ui 'n Use Zone _ {
at 1611 Occupancy
to be occupied only as Sq.feet 2 l00
in accordance with Plans,Specifications and an f d e 1 ar ng Space
Estimated Value of Improvements, $ F*Sprinkler
Emer.Elect.
1 certify that in the performen.a of the work for which this permit is issued I Mall not employ any person
Owner Address le),11 e'y"770.a C'tn'4_
By Address 2'9'7164 j ZZ
This permit Mall 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. 1 1y
FINAL INSPECTION \. � �- y �' �'\, Re0-60V/78
1.LOCATION - 2 DATtRD.. 3 TIA�IERCD.
iAll
4,READY AM ( 7) ANYTIME ( 1 5.TYPE OF 6. INSPT.MADEECIFY INSP CT. TIME
DATE +!
S.APPROVED ( 9.REMARKS: 0 IYI DISAPPROVED (1
INSPECTOR %�✓
280 671 i
WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE