6917 882 Kim St.
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date //— 3 19 77 Permit No.
Application is hereby made for a permit to z9,�2&✓(CAr ri'I oar+so�
a story,Type �—,1VXP� Building Use-Zone
at $ / _ ^� ,/� �y�7i Occupancy
to be occupied only as z r�J "" C`^,,.SQ. feet
in accordance with Plans,Specificatio nd Plot plan filed herewith. Parking Space
Estimated Value of Improvements, ! o • Fire.Sprinkler
/nn � erXect.�(
I certify that in the performance of the work for which this permit is issued I shall not employ any person
in any manner
so as to violate the workman's compensation laws of California.
Owner /�/�/�7�/1 la-//—?e Address /) ;SA A-//Y S1
By �q n� Address J�/7nP
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 3'�� Zy i"Sj�OU�-�/ if 401 260-601 N
I
.ON esueoij sseuisng Al!:)esor ueg
•u geoydde sigl wzuoglne A�iedold pue loeye pae emo;lin;u�si
•oN M8311 s iolaelluoD• e1We;ye3;o ele1S siy leyl slselle lueoyddy
O peel;lueWelelS 'IeuMom
queaydde Aq peW1ep Ageley Si eSOep11 5,Iolaeiluo�io;eiuJo;ye3;oelelS'ol luewel[nbel woal;uo lytlWex3
-
1:LOCATION ' 2. DATE RCD: , •3.TIME RCD.
• 4.READY AM 1' 1 ANYTIME 1 1 5.TYPE OF: 6.AREA 7..I NSPT.MADE 0-5--
PM
SPM ( I SPECIFY INSPECT. TIME
DAT
®
B.APPROVED , 1 1 19.REMARKS:
DISAPPROVED ( )
INSPECTO L
J280-671
WHITE-FILE YELLOW-,INSPECTOR PINK-OFFIC "
•� 1. LOCATION - - I 2.DATE RCD - 3.TIME RCD,.
-gS 3-/3-
4.READY AM ( 1 ANYTIME 1 1 5.TYPE 6.AREA 7. INSPT.MADE
• PM ( ✓) SPECIFY INSPEOF TIME
DATE
III '• '
8.APPROVED ( 1 9. ARKS: - ' -
R
DISAPPROVED ( 1 L( • lhL
I
INSPECTO
671
` - WHITE-FILE YELLOW-INSPECTOR 'PINK-OFFICE .
• 1.LpC�T�ONL , - �2.DATE RCD.ry 3.TIME RCD.
• 4,READY AM'( 1 .ANYTIME ( L1 5.TYPE OF 6.AREA 7. IN PT.MADE_ Ga
PM (_' 1 SPECIFY INSPEC .� 'TIME
.. DATE/.. _
.S.APPROVED ( 1REMARKS
DISAPPROVED
• - N � rvl.Q, -
y
INSPECTOR h /0_7
280-671
- .WHITE;FILE YELLOW-INSPECTOR PINK-OFFICE ,