94648 .. 7556 Bollinger Road -
Building Permit Confiimad ❑
Not Required ❑
CITY OF SAN-JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS
/JPIPING
Q PERMIT
Dafe_.�4..'.J---t --------------------- 19.7/ Permit No._.9_'9__&Z.-U--=---------------
Tha undersigned hereby a es a ing Inspector of the City of San Jose
for a permit to install pu i on the reverse side. .
Exemption from requi enf SYeie of aifornia for.Contractor's license is hereby claimed
by undersigned: a owner ❑ statement filed ❑ 3 O y
Undersigned d efts that his State onia
is in full force end effect and properlya IA'/ 4hi c
Sen Jose City Business License #_
,
I certify that in the performance of the work for which this per i4 is issued I shall not employ
any person in any mannas t v' late t workmen's compensation laws of California.
t
OWNER
ADDRESS Lot No.
USE OF BUILDING
Signed--- --- - ---------- ----' J.
28030
7556 Bollinger RoadPrutn�iRoad
FIXTURES FIXTURES MAIN'DRAIN '
Water 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 I To Main Sewer
Kitchen Sinks Wafer Leaders WATER SYSTEM
Dish Washers Trailer Space Size I Material
Waste Disposals Swim Pool - FEES
Wash Trays . Indirect Wastes Fixture Fee
Washing Machines Drywell Maim Drain Fee '
Water Treat. Equip. - Backflow Preventer Storm Drain Fee
Sinks Survey Water Sys. Fee
Dental Units Gas Piping Fee 5
Drinking Fountains Survey
Permit Fee vi
TOTAL TOTAL FEE
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial �„ „ No. Lines tlets j5ize
Rough 79.7/ 7,IL, Tested and Approved
Finish - - L lay