13793F 1i6� S: ftdiiing k611j
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATI FOR BUILDING PERMIT
Date IN/4' / ( 19� Permit No. /5 9z
Application is hereby made for a permit to J 4_ /1j/� a 7
a story,Type Building Use Zone
at/L[(. S S S11 / Occupancy
to be occupied only as,rS9• feet I
in accordance with Plans,Specifications and Plot-p d her with Pa ,�$$-- pace
Estimated Value of Improvements, $ � '!�y r�& lnkler
Emer. Elect.
I certify that in the Performa of the work for which this permit is issued I shall not employ any person
in any manner so as viol to tl orkmen vs compensation laws of California.
Owner Address 5 ^.-�. /
X%6�
By Address
This permit shall ex 1,1,4nd 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 260-601 N
1
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L167 S. Stelling Rd .
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date-----------....---....-`-.-.`................ 19U/fPermif No.------- D973
The undersigned hereb ekes a lication to the Plumbing Inspector of the City of San Jose
for a permit to install p0 '..'7'""' on the reverse side.
&empfion from req ' n r t o r Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests that his State of C8liforni Contractor's License #
is in full force and effect and properly authorixes �plice '
San Jose City Business License #
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 viol the workmen's compensation laws of California.
OWNER
ADDRESS
USE OF BUILDING LU I —00
leo-ae le-ae Signe .�!10. '-f�/� / ---' ✓-------
1167 S. Stelling Rd./// / Marjorie V. Simonds
FIXTURES FIXTURES MAIN DRAIN
Water Heaters Floor Drains Size ial
Wafer Closets Hoppers To ' To Septic Tank
Bath Tubs Sand Traps RAIN WATER DRAINAGE
Showers Urinals Size Material
lavatories Area Drains To Curb To Main Sewer
Kitchen Sinks Water Leaders WATER SYSTEM
Dish WashersTrailer Space Size Material
Waste Disposals Swim Pool &MainDrain
FEES
jW'shing
Indirect Wastese -
achines Drywell in Feet. Equip. Backflow Preventerin Fee Survey . Fees g Feeuntains - —
TOTALTAL FEE
INSPECTOR'S REPORT HOUSE GAS PIPING�
Partial. No. Lines Outlets Size
Rough Tested and Approved
Finish By
y..�1 U1LLL11V1i 1SVHL
CPF�Fi�
Tract No. ' " Loi No.
CITY OF SAN JOSE BUILDING DEPART SENT
APPLICATION FOR BUILDING PERMIT `y�UZ�
Dat g , 19 7 11 Permit o _
Applicafion is hereby ma for a permit to .._t i e
a_L story, Type �uildi se foyne
at //
— Occupancy
to be occupied only a mg Space
in accordance with Plans, Specifications and fan fi rife Sprinkler
Estimated Value of Improvements, _ / mer. Elect.
-
I certify that in The performance of the work for which this permit is issued I shall naT employ any person
in any manner so s To viola+p;}ha workmen's compensation laws of California.
Owner'? 'f� n)filJ� s d C Address
Address
RECORD OF INSPECTION
Foundation Frame
Stucco Finish
MOM
1171 STEELING ROAD B�Bl�SylIMONS ,`(� 26
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 authorizes this application.
San Jose-City Business License #
280-601 N
1. LOCATION 2. DATE RCD. 3.TIME RCD.
-7 / SB .57-e ZZI.,vS—AIs-�.po, 9130
4.READY AM ( 1 ANYTIME ( )1 5.TYIWOF 6.AREA 7. INSPT.MADE
PM ( 1 SPECIFY-[rINSPECT. TIME
r7/YO✓'✓'O a� T,41✓AVA DATE
8.APPROVED ( 9.REMARKS:
DISAPPROVED (
"BHYAK RE7-Add-)
l
i
INSPECTOR
' 280-671
WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE
6 'CI11"OF SAN JOSE INSPECTION NOTICE
1.LOCATION , 2.DATE RCD. 3.TIME RCD.
4.READY AM ( 1 ANYTIME ( )1 5.TOE OF 6.AREA 7..INSPT.MADE
PM 1, 1 SPECIFY INSPECT. TIME
DATE_9—
8.APPROVED ( 1 9.REMARKS:
DISAPPROVED 1 I/ 1
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STILL Aiee- 1 u " dtr FL I
VDPL//
eCTOR
WRITE-FILE YELLOW-INSPECTOR PINK-OFFICE 280-871
Y CITY-OF SAN--JOSE-INSPECTION NOTICE'
1.LOCATION So _ 2.DATE RCD. 3.TIME RCD.
4.READY 'AM ( - 1 ANYTIME( 1 115.TV OF, '6.AREA 7. INSPT.MADE • {'
-
PM 1 P SPECIFY INSPECT. TIME
,r,• - —y DATE �.
8..APPROVED ( 1 9.REMARKS:
'.DISAPPROVEDf -1' -
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' G S I
- - INSPECTOR
.•• vu r nw_rucoccTna PINK-OFFICE 260-671
—• "I: O. ATI N -- - " 'D _-" — -2. DATE RCD.- '3 TI E RCDf.J --
4.RE'A Y M 1 ANYTI .TYPE OF" 6.AREA 7. INSPT.MADE de
PM 1 .) SPECIFY NSPECT. TIME.
r DATE
• S.APPROVED C 1 9.REMARKS- -
DISAPPROVED ( 1
Q IY1
2 t
•. ppa
INSPECTOR "
• - 280-67,1
WHITE-FILE YELLOW-"INSPECTOR PINK-OFFICE
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