78305 l.3LU r J.ower court
Building Permit Confirmed"}v�=��,\
Not Required c
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date.. ;3 7 .30,
..0.li----.......-------....—'---.... Ie;�. Permit No ------ ------------ -..
Tha undersigned hereby makes a ti t lu Inspector of the City of San Jose
for a permit to install plur I or i a on the reverse side.
Exemption from regw n# r Stat o alt ornia for Contractor's License is hereby claimed
by undersigned: as owner ❑ s}a n4 filed ❑ y
Undersigned attests that his 5#a e o liforn' t Lic se #
is in full force and effect and propE two'.., }hi ap itati
San Jose City Business License # '�—4-d X3
I certify }hat 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 Z;�4, Y�i Scur?
ADDRESS /3a�O F.(0,& CT.
USE OF BUILDINGt1»f uG�
FORM 280-30 10M 1/68 Signed ...VA14s of?qyh--, U(t,j-----'�Z,tpc S'
1320 Flnwar Crruy-t Val S Ptd
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 i To Main Sewer
Kitchen Sinks Wafer Leaders WATER SYSTEM
Dish Washers Trailer Space Size Material
Waste Disposals Swim Pool 1 FEES 7�
Wash Trays Indirect Wastes Fixture Fee
Washing Machines Drywell Main Drain Fee
Water Treat. Equip. Backflow Preventer Storm Drain Fee
Sinks Survey Water Sys. Fee
Dental Units Gas Piping Fee
Drinking Fountains Survey
Permit Fee �,"�. (f 0
TOTAL TOTAL FEE -
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial//.: 5 '(v� �iW�-Pj!/�� No. Line Outlets Size ej
1"
Rough' - -
FinTested and Approved/ - qj�'
ish