11126 (2) 914 Hyde .Averwe L t
Tract No. Lot No. �-�
CITY OF SAN JOSE P- rce.i 75-6.-2-0.-05,3 BUILDING DEPARTMENT
/ APPLICATION FOR BUILDING PERMIT. . -�
Date 6 /��O , 19 11P Permit No.
Application is hereby made for a permit to
a R�2A story,Type & i Use Zone
at /y /f /P 40 L Occupancy
to be occupied only as !
Exemption from requirement for State of California for Contractor's License is hereby claimed by applicant:
as owner ❑ statement filed ❑
Applicant attests that his State of California Contractors License No.
is in full force and effect and properly authorizes this application.
San Jose City Business License No.
I
I
I
• �1 O,CA'T�N / 2. DAT R 3.TIME RCD.
• 4.READY AMI 1 ANYTIME ( 1 S.TYf.9 OF .AREA 7. INSPT.MADE
PMI 1 SPECIFY TIM
DAT
• &APPROVEO � 9.REMARKS:
DISAPPROVED 1 1
r
. INSPECTOR GGA.
780-671
WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE
• 7 0O(C�A/jIC})LN 2. DAT RCD 3. I RCD.
• 4.READY AW611 ANYTIME 6.TYPEOF 6.AREA 7. INSPT.MADE
PM ( 1 SPECIE SPECT. TIME
DATE
• 8.APPROVED - 1 .REMARK
DISAPPROVED ( 1
•
® INSPECTOR
260-671
WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE