00719 V (2) 1168 GARDENSIDE LANE
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
//// APPLICATION FOR BUILDING PERMIT 9/
Date—c/E/� _, 19=7---- Permit No.—<: Q71�1/�a
Application is herebymadefor a permit
a—Z story, Typ �L�/ ���� Buil 'rtg�j��) Use Zone _
at �� e G/z —` �/ `� �/ Occupancy --
Parking Space_
to be occupied only az� -Fi'r Fire Sprinkler _
in accordance with Plans, $pecificati�lot.gmer. Elect.
Estimated Value of Improvements, ;/_l�j�Q�(� /�✓ P76
1 certify that in the performance of the work for which this permit is issued I shall not empiuy any person
in any men er so to violat%the workman's compensation laws of California.
Owner Address �7J y
By E/- Address 00 6
CORD OF INSPECTION ,44,470&e, r4e�So,70
Foundation J, 7 Frame _p-
Stucco Finish Y"�"�'"'4
2 0- 1N
1169 GARDENSTDF LANE NORM COLEMAN
Exemption from requirement for State of California for Contractor's License is hereby claimed by applicant:
as owner ❑ statement filed ❑ /fin
Applicant attests that his State of California Contractor's License
is in full force and effect and properly affi es }h is,ea c p�
San Jose City Business License # — Z
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• 1, LOC 10 � 2. DAT C 3.TIME�Cp-
• 4.READY AM 1 - ANYTIME 1 1 5.TYPE OF 6.AREA 7. INSPT.MADE
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® 8.APPROVED ( 9.REMP.R�S:
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• 280-671
WHITE-FILE YELLOWINSPECTORPINK-OFFICE
• 1.LOCATION 2. DATE RCD. 3.TIME RCD.
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DATE
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• INSPECTOR
280-871
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• 8.APPROVED:ED (
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• INSPECTOR
280-671
WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE
• 1. LOCATION 2. DATE RCD. 3.TIME RCD.
68 G PENSiDE 7-12 2 ;so
• 4.READY AM I,>Q ANYTIME 1 1 6.TYPE OF 6.AREA 7. INSPT.MADE
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• 8.APPROVED ( 1 9.REMARKS:
DISAPPROVED 1
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S INSPECTOR
280-67
WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE