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CIT Lot No. zLo
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date /;9R/? 7__C', ' 19 '?g Permit No. OFi O/ /C
Application is hereby made for a permit to
a _story,Type Bui
at -i Lr ;a,z Use Zone
to be occupied only as `w ,. „ _ Occupancy
Sq. feet
in accordance with Plans,Specifications an Ian I h r wt ar ing Space
Estimated Value of Improvements, E
; S j
.I certify that in the performance of the work for which this permit is issued I shall not em
emlo anin any manner so as to violate the workmen's compensation laws of California. D Y Y person
Owner ii
^� -- Address
BY Address — L'p rThis permit shall 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.
t
FINAL INSPECTION
280$01 N
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1,LOCATK 2.DATER � 3.7 RCD
4,READY AM ( 1 ANYTIME 1 1 5.TYPE OF 6.AREA 7. INSPT.MADE
. `PM (` 1 SPECIFY I SP CT, TIME
• DATE
`8. OVED ( '1' . 9.REMAR
DISAPPROVEDi
•.
• - ..,Y "INSPECTOR CLQ
� 280-671
WHITE-FILE - YELLOW-INSPECTOR PINK-OFFICE ,
va- I
• 1.LO TI N 2.DAT . 3.TIME RCD'.
of
• 4.READY AM ( 1 ANYTIME ( 1 5.TYPE OF 6."AREA 7. INSPT.MADE
PM ( 1 SPECIFY INS CT.- TIME
DATE
S 8.APPROVED T, '9.REMAR .
DISAPPROVED 1 -)
INSPECTOR -
• ` 280 671
WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE
1.LO T 2.DAT 3.TIME RCD.
• 4.READY .AM ( 1 ANYTI 1 1 5.TYPE OF 6.AREA 7. 1NSPT.MADE
PM I. ,) SPECIFY IN E TIME
DATE
' • 8.APPROVED '1 19.REMAR
DISAPPROVED (�)
f. 72 i -
• - ' INSPECTOR ,
280 671
WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE