14168 1191 STAFFORD DRIVE
1-21 7a Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLIC ION FOR BUILDING PERMIT d '�
Dale 1" e� ( , 19K�_Permit No. + Irb
Application is hereby made for a permit to
astory Type Building I _ Use Zone
at �� �--� Occupancy
to be occupied only as v `w Sq, feet Abo
in accordance with Plans,Specification&fend Plot-plant fed herewith. Parking Space
Estimated Value of Improvements, $ 2p- . Fire Sprinkler
}��+ �� /�j2-vEmer. Elect.
I certify that in the performance of tthe�work for which this perm-is issued I shall not employ any person
'nv manners as to. " I laws
Owner Mr WC Address
By 5C Address .1c 2,t7—L,� C• -r .
This 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. ]�
FINAL INSPECTION 0 y 280601 N
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1.LOCA TIO /
/ A
2; TS C 3,TIME RCD.
L6
4•READY AM ( 1 AN T ( 1 5.TYPE OF 6.' EA 7. INSPT.MADE
PM ( 1 SPECIF I SPECT ! TIME
1 DATE•
8.APPROVED ( L 9.REMARKS:
DISAPPROVED ('��- 1
F3 Tiq
C
• INSPECTOR
280-671
WHITE-FILE YELLOW-INSPECTOR•, PINK-OFFICE
1. LOCATION 2. DATE RC6, 3.TIME RCD.
4.R ADV AM ( 1 YTIME ( 1 :d�PE OF EA 7. INSPT.MADE
PM 1 1SPECIFY ECT. TIME
DATE
8.APPROVED 'f,�e4 9.REMARKS: `„�S& C �/1 rt el '
DISAPPROVED ( 1 7t rl
INSPECTOR
280-671
WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE