7376 7464 Yill;enleaf Lane
Building PermitConfirmed ❑
Not Required .—�—
,CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Da+e----FebrUdry_22--------------- 19...74 Permit No......
. .�.
The undersigned hereb ekes application to the Plumbin Inspector of the City of San Jose
for a permit to insfall l a a reverse side.
Exemption from req ' n r fa of if n' r nfracfor's License is hereby claimed
by undersigned: is owner ❑ statement filed ❑ 228671
Undersigned attests that his State o California Contractor's License #
is in full force and effect and properly a i f*tes this a lie 29 S 7
San Jose City Business License #
I certify that in the performance of the work for which this permit is issued I shall.nof employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER John Taylor
ADDRESS 7464 Fallenleaf Lane Lot No.
/ USE OF BUILDING residence
128030 Aug. 69 Signed..C/ 4 /'V... { ae..Go --
13y
7464 Fal 1Pnleaf .Tune v7.11iRan
FIXTURES FIXTURES MAIN DRAIN
Wafer Heaters Floor Drains Size Material
Wafer Closets Hoppers To 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 Material
Waste Disposals Swim Pool FEES
AUnits
Indirect Wastes Fixture Fee
chines Drywell Main Drain Fee
Equip ,00 Backflow Prevenfer Storm Drain Fee
Survey Wafer Sys. Fee -1.00
Gas Piping Fee
ntains - Survey
Permit Fee 2.00
TOTAL ,0 TOTAL FEE ¢,00
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial No. Lines Outlets Size
Rough Tested and Approved
Finish By