81359 7564 Defoe Drive
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date._._IAIK,y_.....`.��..�....... ........196,9 Permit No. ._.//. 1.35�1..---._......_.
The undersinaUd herb mak egg I' ion fo he Plu� Inspector of the City of Sen
Jose for a undersigned
t ' s 7 p f u nd o es listed on the reverse side
hereof, and agrees ai st an r es accordance with the provisions of
Article VIII, Chapter 2, f the San Jose Municipal Code, and all other laws applicable
thereto.
I certify that in iha perfo enc f the or is �p r nit is issued I shall not
employ any parson in any m r so as i w k s compensation lows of
California.
OWNER
ADDRESS
USE OF BUILDING Du'
^ ft IIS J .O.
FORM 280-30 3/65 10M Signed ..... ...... ... .�. . A'i«','��f-{� �D�{ZOAD"���
REDWOOD CITY C
7564' Defoe Drive Alwin Plumbin 6�I.F. 365-0714
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 I Material
Waste Disposal Sd Swim Pool FEES
Wash Trays Indirect Wastes Fixture Fee
Washing Machines Dr well
ain Drain Fee
Water Treat. Equip. Backflow Preventer Storm Drain Fee
Sinks Survey Water Sys. Fee
Dental Unifs Gas Piping Fee
Drinking Fountains Survey
Permit Fee Z p d
TOTAL TOTAL FEE o Q
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial No. Lines Outlets
Rough Size
Tested and Approved
Finish .L L . By