75526 1495 Aster
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Dafe-_�ri- ---- ----------------- 19-(r.8�//,/rmit No...-.---..-�7.•T3—� G _
y The and ersigne er as ¢ n fy�Mrl�f u in�ctor of the City of San Jose
for a permit +o in it ur nd (pipp d ""Ih re.erse side.
Exemption from require nt for Sfate of Ce ifor a for Con rector's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests that his State of California Contractor's License # 7 .90 9
is in full force and effect d properly aulhorixes this application.
San Jose City Business ens
I certify that in the 7.rf an of the r i s a s I shall no4 employ
any person in any man o s viola}e + rr //e om ns f� of California.
OWNER 77�� �v A .,U., -
ADDRESS 1Y9 f ��
USE OF BUILDING Z-
FORM 280-30 10M 1/68 Signed -----. .
C� �'� ce
1495 AsterX
FIXTURES FIXTURES MAIN DRAIN
Water Heaters Floor Drains Size Material
Water 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 Washers Trailer Space Size Material
Woste Disposals Swim Pool FEES
Wash Trays Indirect Wastes Fixture Fee
Washing Machines Drywall Main Drain Fee
Water Treat. Equip. Backflow Preventer Storm Drain Fee
Sinks Survey Wafer Sys. Fee
Dental Units Gas Piping Fee
Drinking Fountains Survey
Permit Fee
TOTAL TOTAL FEE
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial
Rough No. Lines Outlets Size
Tested and Approved
Finish By