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Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
o APPLICATION FOR BUILDING PERMIT
Date O — /S^ . , 19 !77- Permit No. C,' 5 v P I
Application is hereby made or a�pjerjmFjit�t,o� ✓ - <
a story,Type�BuilGlny Use Zone
at u/y Occupancy
to be occupied only as �c O Sq. feet
in accordance with Plans,Specifications and Plotfpl�ar�" hcrewith.r�Pa ngtSpa e
Estimated Value of Improvements, $ wd/Fire Sprig leri
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 me or
as to violate the woikmen's c'o� mp1ensation laws
�ofpCalifornia.
Owner rs ` f 'TM'I A+�Address ( J /sem GJ✓C�2'
By Ci4; L Address rp" e:(_ "'/ lqt._
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 INSPECTION U �17z 260.601 N
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• 1.LOCATION 2. DATE RCD. 3.TIME RCD.
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• 4.READY' AM 1 1 ANYTIM0 1 5.TYPE OF 6.AREA 7. I SPT.MADEI..
PM ( -) ECIFY INCE• T. TIME _f!
�. DATE .2 ,7
• B.APPROVED 1 1 9. EMARKS: -
DISAPPROVED 1 1
•
• INSPECTO
671
WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE
• 1.LOCATION /w 2. DATE RCD. 3.TIME RCD.
• 4.READY AM (,X ANYTIME .. 1 5.TYPE OF 6.AREA 7. INSPT.M^^A��DE3S
PM ( 1 SPECIE ' 4 IN RECT. TIME L
DATE
• 8.APPROVED ( 1 9.REMARKS:
I
DISAPPROVED ( '
as
• " INSPECTOR CI i.l�7
280-671
WHITE-FILE YELLOW-INSPECTOR PINK OFFICE
• 1, LOCATION t - 2. DATE RCD. 3.TIME RCD.
4,READY AM ( 1 ANYTIME ( 1 5. VPE OF. 6.AREA 7- INSPT.MADE.
•. PM 1 1 SPECIFY IN ECT- TIME '
DATE
• 8.APPROVED ( 1 9.REMA KS: -
DISAPPROVED ( 1/1'
Lf
INSPECTOR-fid e
• .. 280-671
WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE
� • 1. LO CATION�3 2 DATE . . 3.TIME RCD.O
• 4•READY AM 1 . 1 ANYTIME 1 1 6.TYPE OF 6.AREA 7. INSPT.MA DE
I'f
PM ( 1 SPECIFY iNS CT, TIME ��(]
.. . , .. DATE
^ • B.APPROVED . (. 1 9.REMARKS:
DISAPPROVED 1 •,)
• INSPECTOR
280-671
WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE
• 1.LOCATION ' 2.DATE RCD.' 3.TIME RCD.
L -
• 4,READY AM (- 1, ,ANYTIME 1 1 5.TY OF 6.AREA 7. INS/r MA E�
PM ( 1 :, E 'IFY - IN
SPEC TIME
DATE
O &APPROVED ( 9.REMARKS• • '
DIS APPROVED1 1
-. INSPECTO .
280-671 .
NSPECTOR
WHITE-FILE YELLOW-1 'PINK-OFFICE