12253 841 Stendahl Ln.
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date 4/4.i r7— , 191rh Permit No. 2s- JT7
Application is hereby made for a pe mit to el, I
a �_story,Typefs�eWZone
at 0
ancy
to be occupied only as /rte flx- r ox !
in accordance with Plans,Specifications and Plot-p an filed herewl[h. Parking pace
Estimated Value of Improvements, $ 3R Fire Sprinkler
Emer. Elect.
I certify that in the performance of the work for which this permit is issued I shall not employ any person
in any manner so as to violate the workmen's compensation lawns\of California.
Owner— 4w �.\\'1-� Address
By -::::9 _ \ Address 4:-,—,'Ns"
This permit shall expire and beco a 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. .. I
FINAL INSPECTION 1 260-601 N
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DAT
.APPROVED 'I' 9.REMARKS: -
DISAPPROVED ( 1
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INSPECTOR fiLfl GG( ,
280-671
WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE
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1. LOCATION 2. DATE RCD.p� 3.TIME RCD.
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•. 4.READY AM ( 1 ANYTIME (' . 1 S.TYPE OF 6.AREA 7. INSPT.MADE
PM '1 ') - SPECIFY IrjsPECT. TIME
DATE d
• S.APPROVED OVE ( 1 9.REMARKS:. -
DISAPPR ,. )
- INSPECTOR
I 11280!671
WHITE-FILE - - YELLOW_INSPECTOR PINK-OFFICE
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