13305 (2) 7523 FALLENLEAF LANE
10c 2 7 p Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date • 119 Permit No. / _q O�5— TL
Application is hereby mad fora permit to
a story,Ty V N Zr uilding Use Zone �-
at Occupancy
to be occupied only as
�S Sq.feet
in accordance with Plans, e f n I �e dherewith. Parking Space
Estimated Value of Impr a en % ` yP �— Fire Sprinkler
AWffww�x Enter. Elect.
• I ie" rtify that in the performance of the wo for which�[(is permit is issued I shall not employ any person
in any manner so to violate t¢o workman's compensation laws of California
^ {
Owner p"^� Address
6Y Address 217.`/ / atS'Woc+�/" O�iP. S•�i
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 INSPECTIOON�' 280-601 N
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DATE
8.APPROVEDh(') 9.REMARKS:
DISAPPROVED/(\' 1 '
INSPECTOR C ke,
280-671
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