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3884 1118 Derbyshire Drive x Tract No. Lot No. CITY OF SAN JOSE BUILDING DEPARTMENT APPLICATION FOR BUILDING PERMIT Dat TZ1'(')�. 21 . 19_!�—__— Permit No. Application is hereb made for a permit to qj .I< clo a 2_s+ory, ypeyn_'�S— Building_ Use Zone rr Occupancy to be occupied on as Parking Space in accordance with Plans, Specificafio�lot--plan filed herewith. Fire Sprinkler. Emer. Elect. Estimated Value of Improvements, .$ I certify that in the performance�of the work for which this permit is issued I shall not employ any person in any manner o as to violate'the workmen's compensation laws of California. r Owner �@t� l Address li By rV Address 1�cavr-+c—� RECORD OF INSPECTION Foundation _ Frame Stucco Finish _ 260-601N 1118 Derbyshire Drive 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 Contractor's License # is in full force and effect and properly authorises this application. San Jose City Business Lice�ng # 77 drn- aQ 280-601 N : 711 Y.LOCATION, 2. DATE RCD. 3.TIME-RCD. y . 4.READY AM ( I .ANYTIME ( L-5 .TYPE OF 6.AREA 7. INSPT.MADE - PM ( 1 SPECIFY - INSPECT. TIME ' -. � 'DATE S.APPROVED ( 9.REMARKS: DISAPPROVED ( f. i 'INSPECTOR 1-GW 260 671 ' OFFICE WHITEFILEPINK- ' r . • 1. LOCATION 2. DATE RCD. 3.TIME RCO. • 4.READY, AM ( 1 ANYTIME 1 1 5.TYPE OF 6.AREA 7. INSPT.MADE PM 1 I SPECIFY INSPECT. TIME 5. 0 .46 DATE (i B.APPROVED -1 1 9.REM�ARR S. - > DISAPPROVED, ( ) i 0 , • INSPECTOR' 280-671 WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE - 1. LOCATION - 2.-DATE RCD. 3.TIME RCD.' S 4.READY . AM ( 1 ANYTIME ( 1 5.TYPE OF 6.AREA 7. INSPT.MAD.0.- PM 1 1 SPECIFY • NSPE TIME DATE o. 2-27 • 8.APPROVED ( 1 9.REMARKS: DISAPPROVED ( 1 • - - INSPECTOR KP, I'L�►CJto L 280-6]7' WHITE-FILE YELLOWINSPECTORPINK-OFFICE .1. LOCATION // �2.DATE RCD 3.TIME RCDlf . • 4.READY AM ( 1 ANYTIME 1 5.TYPE OF 6.AREA 7. INSPT.MADCE PM ( 1 SPECIFY NSPEC TIMEL/-7 =] go DATE 7 • B.APPROVED ( 1 9.REMARKS: DISAPPROVED .1 1 0 • INSPECTOR ° `- 280-671 WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE - 7,7 • 1.LOCATION 0 ' 2. DATE RCD. 3.TIME RCD. 4.READY AM ( 1 ANYTIME ( 1 5.TYPE OF 6.AREA 7, INSPT.MADE • PM I. 1 SPECIFYINSPECT. TIME ? SOV DAT // • &APPROVED ( 1 9.R MARKS: �L .DISAPPROVED 1 l� - Ie (i P E 'JI WA • L -a INSP CTOR • 280-671 WHITE-FILE YELLOW-INSPECTOR PINK:OFFICE N ,2.DAT RCD. 3.TIME RCD. 4.READY AM ( 1 /ANYTIME ( 1 5.TYPE OF 6.AREA 7. INSPT.MADE PM ( I SPECIFY / T TIME DAT S.APPROVED ( 1 9.REMARKS.. • DISAPPROVED ( `) I � o INSPECTOR - • _ i'Q 280-671 WHITE-FILE :.YELLOW-INSPECTOR PINK-OFFICE