9513 7564 Deaoe Drive
Tract No. Lot No.
i CITY OF SAN JOSE
BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT_ �5
Date , 19 P�ramit No.
Application is hereby made for a permit t- ` °_
a st ry,T�(pe Building
Use a e
at 7 I./t 5 Occupa cy
to be occupied only as Sq•feet
in accordance with Plans,SpeciOatiorls and Plot-plan filed herewith. Parking Space
Estimated Value of Improvements, $ !S Fire Sprinkler
� Q/�/- Emer,Elect.
I certify that in the performance�lleyrork fa/wM" is rnfjtwS� ued I shall not employ any person
in any manner so`}-as to v olate the workmen's compensation laws of Calii/orma. f�
OwneL� I—�Cl�l v� di.., Address -7S l q DP V O-F
By I "�• Address qIG . 2,,, t•vIDr�.4,: ,� GC 0 C
Thi p mit shal expire and become nu and void 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.
I
FINAL INSPECTION 260601 N
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-'-s . ED¢ RES! j :' FIXTURES `; MAIW RAIN
F,Water,Hecters IF(oos.Drains` ISze' _ _ _ Mcteridl - r�
(.Witei, Cibsets. ,Hoppers' ., '.i To `_ ,To.SepticTrank:
Both .T+ubs „Sand'Tmps LAIN WATER DRAINAGE
I'S6oweri -`''UAncls . - - Srie - - Material' _(
(Lavatories Area Drams i ITo Curb 116 Main Sewer
[Xitchen.Sinks -l� !WaterLeaders _ WATER: SYSTEM,
('Dish Washers- _ Trailer Space,..:: ,Srze ; Materials _
kWaste'Disposcl_ , .,.% SO !Swim Pool 4 -"' FEES -�
r.
(•Wash. Trays, ',I'ndi"rect Wastes tRiture'Fee
Washrri 'Machrnes,' - D well - _j' . 'MamDiain'Fee` I' '• .I "
Water'�FreoT Equip. +Backflow Pre4enter Storm' Drain- Fee,' i -
45'urviry - fWciter,, ys Fee
k '
(Dental Upits r-� -"- i` ' teas Rpng Feer
IDnnkingFountains.' ;, - .�. - - i1 Survey: ..- .-_ •�r - .
( - - - - -- -
-Permit Fee'. - ` Z O o _'�
( TOTAL: TOTAL FEE
- INSPEGTOR'S'REPORTF HOUSE' GASIPIPING j
(P.dArdl' - - - - 'No. Lines - • ,�Oufiets; :;Size _
FRoug6,- - - - Tested ,dna Approved •�
I'Finrsb. -Z-G -