7429 (2) 1146 Derbyshire
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
7 APPLICA=to -
ING PERMIT
Date 7 19t No. a
Application is hereby made for /o r7 az_T-_
a _�story,Type,EBuilding Use Zone
at r - i Occupancy
to be occupied only a c ,_,- Sq.feet
in accordance with Plans,Specific ons a Plot-plan filed herewith. Parking Space
Estimated Value of Improvements, $ Fire Sprinkler
E r.Elect.
1 certify that in the performance of the wor fo hich t is permit is issu I I not employ any person
in any
manner so as t vi late the workmen's compensation//laws of California.
Owner/ st AddresY.� �"
Addres�i�—l� Q_Lj` -6 .
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. C+
FINAL INSPECTION o/w/0 Ak - 260-601 N
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