88272 7889 Belknap Drive
Building Permit Confirmed ❑'
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATIQN FOR PLUMBING and/or GAS PIPING PERMIT
Date.-...:----. ..�y.------------- ----------- 19 '72) ermj+ No.. .. _�---------------
The undersigned creb p Y h I }or of the City of San Jose
for a permit i incl II % r d r p es I e a reverse side.
Exemption from require men for State of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests that his State of California Contractor's License #_a,;7-9—/17—
is in full force and effect properly authorizes is a r lie fi s.
San Jose City Business
I certify that in the p rf ce of the w/Vo w c is� ermi s ed I shall not employ
any person in any manner } violate the workmen's compensation laws of California.
OWNER Dlf Dle i
ADDRESS / Lot No.
USE OF BUILDING /' _•Ref / p
28M0 Au9.169 SignedWCX.11.' ...5/1 /sZJ:..�/---C'�: ........
7889 Belknap Drive Ace Plumbing
FIXTURES FIXTURES MAIN DRAIN
Wafer Heaters Floor Drains Size Material
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 Wafer Leaders WATER SYSTEM
Dish Washers ITrailerSpacekizeMyaterialMaterial
Waste DisposalsoolFEES
Wash Trays Wastesee
Washing Machines ain FeeWafer Treat. Equip. w Preventerrain FeeSinks s. FeeDental Units ng'FeeDrinking Fountains eeOTALOTAL FEE so
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial No. Lines Outlets Size'
Rough Tested and Approved
Finish By