16306 'Rebiindell W4Y— V
Tract No. /\ Lot No. 11-3
CITY OF SAN JOSEBUILDING
FOR BUILDING BUIpyLD TG DEPARTMENT
P.C.D
at i69 ICS,.Jrb li
Date _ 2T , 19 Permit No.
Application is hereby made fora ermit to 4 fD0 �WSr`- (D �-(."Y
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a 1_story,Type uil i Use Zone 91 /
at 7,P,� 3 ',Pn � .� // � Occupancy ✓
to be occupied only as L A Sq.feet ? 1
In accordance with Plans,Specifications a dP plan fil d he e i arki g Space z
Estimated Value of Improvements,$ Sprinkler
DF Emer.Elect.
g1 certify that in the performance of the work for which this permit is issued 1 shall not employ any person
owner '�,� .�� r Address 7��3 �v-6�;-r�.GeG �✓�l
9 . Address
I
This permit shall expire and b null and void if the work authorized by it is not commenced within
120 days from the date issued or the work is suspended or abandoned for a period of 120 days after
commencement
FINAL INSPECTION , ' ' " "Y " 28"01g^�Rev. 78
T
Exemption from requirement for State of California for Contractor's.
License Is q aimed by applicant:
M owner statement filed❑ t
Applltanta this State of California Contractor's License No.
Is in fullf a and effect and properly authorizes this application.
San Jose City Business License No.. ,
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• - 1.LOCATION 2.DATE RCD.. 3.TIME RCD.
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(� DATE r
8.APPR ED ( �. 9.REMARKS:
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280 671
WHITE-FILE YELLOW-INSPECTOR, 'PINK-OFFICE
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• _8.APPROVED '�1� : 9.REMARKS: ..�W
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• - - - INSPECTOR
280-671
WHITE'-FILE YELLOW-INSPECTOR PINK-OFFICE
1. LOCATIO 2.DATE RCD. 3. IME RCD.
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280 71
WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE