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72127 7619 Erin Building Permit Confirmed ❑ Not Required CITY OF SAN JOSE BUILDING DEPARTMENIT APPLICATION FOR PLUMBING and/or GAS/ PIPING PERMIT Dafe----YlL©.---------- 196.1 Permif No.----- 7--------------------- The undersigned hereby m •es applicafio {he/gjnbing �cfor of the City of Sen Jose for a permit to install plum n f' u s / ip li reverse side. Exemption from requir �e o e rnie or on actors License is hereby claimed by undersigned: es owner ❑ statement'% L' ,-* Undersigned d attests that his State of As-this Contra to'% L}'¢an�9eyQk is in full Force and effect and properly au `- r40s a is Sen Jose City Business License #' `2- 1 certify that in the performance of the work for which this permit is issued I shall not employ any person in any nner so as to vol to the workmen's compensation laws of California. OWNER ADDRESS0L �J USE OF BUILDING FORM 280-30 10M 3/67 Signed. -------- ... ------- -- 7619 Erin Ace FIXTURES FIXTURES MAIN DRAIN Wafer Heaters Floor Drains Size Material Wafer Closets Hoppers I .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 Maferial Waste Disposals Swim Pool FEES Wash Trays Indirect Wastes Fixture Fee ,C) 0 Washing Machines Drywall Main Drain Fee Wafer Treat. Equip. Backflow Prevenfer Storm Drain Fee Sinks Survey Water Sys. Fee Dental Units Gas Piping Fee Drinki#g,Fountains Survey Permit Fee ,Z.O 0 TOTAL TOTAL FEE '06 INSPECTOR'S REPORT HOUSE GAS PIPING Partial No. lines Outlets Size Rough �., ,•,, Tested and Approved Finish (/� V By