4478 (2) 100 rIf iky to-Ay
Tract No. Lot No.
CITY OF SAN JOSE . BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date , 19'7 Permit No.
Applicatio Is hereby made for �mit
a story,Ty 4
Use Zone f�/
at Occupancy ✓
to be occupied only as
in accordance with Plans,Specifications pd P t-plan filed herewith. Parks g pace
Estimated Value of Improvements, $ Fire Sprinkler
Emer. Elect.
1 certify that in the performance of the work for which this permit is issued 1 shall not employ any person
in any manner so as to violate the workmen's compensation laws of California.
Ownerf , P Address /0 q�Z 11
7 JT
Address //' xa2/Bytp.-rm.t's�hlim
nvod �
la.d
if the work authorized by it is not commenced within
120 days from the data issued or if'the'work is suspended or abandoned for a period of 120 days after
commencement.
FINAL INSPECTION /�A / /� wJ 260-601 N..
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• 1:LOCATION 2. DATE 3.TIME Fj
•, '4•READY,. 'AM ( )• ANY (. 1 5. E OF 6.AREA 7. INSPT.'MADE _
��Q � PM ( 1 � SP Y' • PECT. TIME �D
,6ej, DATE S Z
• 8.APPROVED ( , •) 9.REMARK
DISAPPROVED
40;1 z Jew Are
INSPECTOR 7
• - 280-671.
' WHITE-FILE 1 ,'�YELLOW-INSPECTOR '.PINK-OFFICE
• 1.l / 2.DATE RCD.. 3.TIM RCD.
,� 6, • _ _
• 4.READY AM ( 1 ANYTIME 1 1 .TYPE OF 6.AREA 7. INSPT:MADE '
i
PM 1, 1' SPECIFY INSPECT. TIME
DATE
• 6.APPROVED 1 1 9.REMARKS:
DISAPPROVED 'I A-�ol
•• is
• -• INSPECTOR
280 671
–
�WHITE;FILE YELLOW-INSPECTOR PINK-OFFICE
1.LOCATION 2. DATE RCD. 3..TI E RQD. . .
• 4;READY AM ( I' ANYTIME 1 - .) 5.TYPE OF 6.AREA 7, INSPT.MADEJ/
'PM ( ':'') SPECIFY - TIME�/ 3D
DATE
- • 8.APPROVED -1 1 9.REMARKS-"
DISAPPROVED ( 1
r .
• INSPECTOR
260-671
WHITE-FILE YELLOWINSPECTORPINK-OFFICE