Loading...
21128 7895 FIESTA LANE Building Permit Confirmed Not Required ❑ CITY OF SAN JOSE BUILDING DEPARTMENT APPLICATION FOR- PLUMBING and/or GAS PIPING PERMIT zl-� 7=----- - Da#e-------- -- --- - - - -------- 19L.-fes-Permit No.------------- - ------ The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose for a permit to install plum � r pipes' •sf9V }he reverse side. Exemption from regwremen for S 1 o Girdo i o nlracfor's License is hereby claimed by undersigned: as owner ❑ statement filed 0 Undersigned attests that his State of Ce b�,'�=Contr�ggAtor i ns is in full force and effect and properly authu�i.2e h. ap o;ti, San Jose City Business License #'— I- ' ���3�✓(/ I-certify that in the performance of the work for which this permit is'issued I shall not employ any person in any manner so as/to violate the workmen's compensation laws of California. OWNER ADDRESS ��� �51Tia LAi✓E Lot No USE OF BUILDING S/NGC ! 64* 280-30(9-73) Signed y4'7lfZf./ (2'- -----7rT.. e:-s------------"------ 79q.5 'FIESTA LANE 4 •ADMIRAL POOLS FIXTURES NO. FEEI AIN Nater Heaters ° �� I Size IMaterial Water Closets To I Fee Bath Tubs RAIN WATER DRAINAGE Showers Size iMalerial Lavatories To Fee Itchen Sinks WATER SYSTEM Dish Wgsher Size Material Waste Disposals Water Fixture Fee Nash Trays HOUSE GAS PIPING Yashing Machines No. Lines I Outlets Nater Treat. Equip. Size j Y y ltee Sinks FEES Dental Units Fixture Fees Drinking Fountains Main Drain Fees Floor Drains Storm Drain Fees Hoppers Water Sys. Fee Sand Traps Gas Piping Fee Urinals Survey Area Drains Permit Fee O Water Leaders TO AL FEE Trailer Space INSPECTOR'S REPORT Swim Pool Gas Piping Indirect Wastes Ap rov d ,�Z.7 )rwell B wz 3ackflow Preventer Partial iurvey Approved /Q B Rough TOTAL Approved ' B Finish Approve B �iP Gus