5928 (2) 11'18 Derbyshire Drive C .ta IChFtit/�
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPART
APPLICATION FOR BUILDING PERMIT���
Date '?-1,5 ' 19 77 Pgrrpit f{o.
Application is hereby m for a permit to 5L X
a /T_yp,,e i , V V Use Zone
at CK6Y Occupancy
to be occupied only as Co 7 Sq.feet
in accordance with Plans,SpecifiEations an t•plan filed herewi arking Space
Estimated Value of Improvemeny8 Sprinkler
mer. 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 laws of California.
Owner Koagy I-SH1.6SO . Address
By Address
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. yn� / .
FINAL INSPECTION ��7?r`� CU114.41 260601 N
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1128 Derbyshire Drive
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date' 3 19_77 Permit No.
Application is hereby ma��de for a permit fo
a__ Z__story, T pe i_L�% Building _ se Zone / —/
at 0, _ ,^ Occupancy
to be occupied only as ,/AV/w/ Parking Space
in accordance with Plans, Speci ications and Plot-plan filed herewith. Fire Sprinkler
Emer. Elect.
Estimated Value of Impro ;
I certify that in the parlor a e wor r i`- i} issued I shall not employ any person
in any manner so'as to viol e t rkmen' e f ew elifor 'e. yp
Owner 1116 DA Address
By n (L C Address
RECORD OF INSPECTION
Foundation Frame
Stucco Finish
r260-601N--
1128
260-601N-1128 Derbyshire Drive
N 109-09z
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LOCATION 2. DATE RCD. 3.TIME RCD.
• • 4.READY AM ( 1 ANYTIME ( 1 5..TYPE OF 6.AREA 7. INSPT.MA
PM It 1 SPECIFY INSPECT. TIME
DATE_
• 8.APPROVED 1 1 9.REMARKS:
DISAPPROVED •1 1
• INSPECTOR
280-671
WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE
• 1, OCATION ` 2. DATE RCD. 3.TIME fiCD.
17 i 2. - Zi-7 3Old
4,READY A®1 1 ANYTIMEI 1 5.TYPE OF 6.AREA 7. INSPT.M/2E'
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DATE
• 8.APPROVED ( 1 / 9.REMARKS:
DISAPPROVED ( v 1
® - ,INSPECTOR7�
WHITE-FILE YELLOW-INSPECTOR. PINK-OFFIC
• 1.LOCAT ON 2. T CD 3.TIME RCD.
• 4.READY Am ( k/) ANYTIME 1 1 5.TYPE OF 6.AREA 7. INSPT.MADE
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DATE
8.APPROVED ( `1 9.REMARKS:
DISAPPROVED 1 1/ 1
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• - INSPECTOR r -✓
280-671
WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE
r1.LOCATION 2. DATE RCD. 3.TIME RCD.
fd:�� 4j 77
III • ' 4-READY AM ( 1 AN TIME ( - 1 5.TYPE OF 6.AREA .7. INSPT. ADE
PM ( 1 -SPECIFY N ECT. .TIMES 3 O.
DATE
• 6.APPROVED 1 I 9.R MARKS: '
DISAPPROVED I ✓) maO
•
INSPECTOR _
zso.s�T
WHITE FILE YELLOW.-INSPECTOR PINK OFFICE
• 1, LOCATION A -- �•' 2. DATE RCD. 3.TIME RCD.
• 4,READY AM ( 1 ANYTIME 1' 1 5.TYPE OF 6.AREA^7. IN PT.MADE'
PM ( 1 SPECIFY SPECT TIME
DATE
• 8.-APPROVED ( 1 / 9.REMARKS: ,
` DISAPPROVED 1 ✓ 1
0
• INSPECTOR
<_/. 280 571
WHITE-FILE YELLOW INSPECTOR PINK-OFFICE ,
• 1.LOCATION 2. DATE RCD. 3.TIME RCD.
C�
• 4.READY ,AM ( I ANV ME ( ) 5.TYPE OF .6.AREA 7. INSPT.MADE
PM ( 1 SPECIFY INSPECT. q TIME
/ DATE
• B.APPROVED 9.REMARKS: - . .
DISAPPROVED I. 1
t
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•
• INSPECTOR r
280-6
WHITE-FILE YELLOW INSPECTOR PINK-OFFICE
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• 1. LOCATION 12'CATE RCD. 3.TIME RCD.
• '4.READY AM ( 1 ANYTIME ( .) 5.TYPE 9F 6.AREA 7. INSPT.MADS
PM ( 1 SPECIFY T. - TIME 4
DATE
• 8.APPROVED ( 1 9.REMARKS:
DISAPPROVED ( 1
INSPECTO
/ 280-671
WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE