16136 '80i-803 Miller' Ay��--6 2— ) /
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMELNT
P.C.Date APPLICATION FOR BUILDING PERMIT
Date ,19 Qe 't No.
Application is hereby made for a permit to tp W., 3a '6° a
a ,Ty Building se y. UZone
at D sto h Occupancy
to be occupied only as ja 1140a Sq.feet /1ST d
in accordance with Plans,Specifications and Plot-pla fi(gd herewith. Parking Space
Estimated Value of improvements,S Fire Sprinkler
❑1 certify th in the rtes a th woFk/for whi thb pen I d shall t owPloy emr person
Owner I K) N Address Act MIL
r t_C _ AUC—. .
By Address A N 3-OS'C--;
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 � Rev?T78
622.3 ✓ticehzL A-ciii,9L a01-63 / IIPN Ate. i
Exemption from requirement for State of Celifomla for Contractors. ,
license Is hereby claimed by applicant: '
asomer0 statement filed
Applicantattests that his State of California Contractors License No.
Is in full force and effect and properly authorizes this application.
San lose City Business Llcerrse No.
• 1.L ATI ON 2. DATE RCD. 3.TIME RCD.
• 4'READY AM ( 1 ANYTIME ( ) 5.TYPE OF 6..AREA 7. INSPT.MADE
PM ( I. SPECIFY INSPECT. TIMEi
DATE . i
8.APPROVED ( 7V 9.REMARKS: '
• _ . DISAPPROVED
•
•
INSPECTORi
280 671
WHITE-FILE YELLOWINSPECTORPINK-OFFICE
ATIO � � TE RCD. , 3.T ME RCD.
4;READY- AM ( 1, ANYTIME ( 1 5.TYPE OF 6.AREA 7. INSPT.MADE
PM ( 1 SPECIFY - SQECT. TIME
9 DATE
&APPROVED: t�1- 9.REMARKS:
DISAPPROVED
^ r= Tr� "
. INSPECTOR G
.288-.671
WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE