17220 (2) Tract No.
' '7580' Shadawhill ����
Lot No.
CITY Of SAN JOSE IIIJILDING DEPARTMENT
A LICATION FOR BUILDING PERMIT
Date , 19 Perm't N .
Application is hereby made for permit to
a story,Type Building _ UseZorle
at 5 '4/ 6 X/S�� Occupancy---
to be occupied only as 1 /1l/&'�pT C«/, Sq.feet
in accordance with Plans pec
and Plot Ian fid herewith.Parking Space
imated Value of Improvements,S _/���� X Fire Sprinkler
Emer.Elect.
1 certify that in the performance of the wont for which this permit is kgrsd 1 sh I not employ artyperson
Owner Address
By r Address
This permit shall expire end 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 1211 days atter
commencement
FINAL INSPECTION Revaee�/78
�a6S9 �i�D
760 :�Bvowd�,c,C ,C.�V
Exemption from requirementfor state of California for Contractors.
license is hereb laimed by applicant:
asownerl� statement filed El
Applica t attests that his State of California Comractoes License No.
Is in full force and effect and properly authorizes this application.
Ian low City Business License No.
0
rnl
i
CITY OF SAN JOSE • NOTICE
1.L ATI "O�')
`.DATE . 3.TIME RCD.
4.READY, A5.TYPE OF6.AREA 7. INSPT.MADE
P ��T' TIME
DATE
8.APPROVEDDISAPPROV
r
INSPECTOR
280-671
WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE
zt Z I &
. LOCATION n 2.DATE RCD. 3. E RCD.
(o 10Y
r7 '4:READY AM ( 1. ANYTIME ( 1 5.TYPE OF 6.AREA 7. INSPT.MADE
PM (' 1 -SPECIFY INSPECT. TIME
/ DATE
8.APPROVED ( 9.REMARKS:
DISAPPROVED ( 1 M
INSPECTOR C.
280 671
WHITE'-FILE, YELLOW;INSPECTOR PINK-OFFICCE
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INSPECTOR
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