3925 15173 Galway Dr.
Building Permit Confirmed 0
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
(p.-.o �% z��
Date......---- ---------------- 19-73. Permit No.---------.----------.......---------------
Tho undersigned hereby m es aPw
tio to a Plumbjp Insp %jor of +ha City of Sen Jose
for a permit to install plum g o i es a r ers. side.
Exemption from require a u f fr ors Licensg�is hereby claimed
by undersigned: as ❑ statement filed A
Undersigned attests that his State of California Contractor's Licence#
is in full force and effect and properly a ri }his a ' t'
San Jose City Business License # —AP
I certify that in the performance of t e work for which this permit is issued I shall not employ
any person in any manner sox as to �i late t�kmen's compensation laws of California.
OWNER_ .w,0.".Y^j/t. (/
ADDRESS _�Ip_/s+ , n . • Lot No. 3g
USE OF BUILDING
O A
28030 Signed---------- . . ..--- - - ---- -
rUXt-
Ir 1���� Blue ChamnaRne Pools
FIXTURES NO. FEE MAIN DRAIN
Voter Heaters Size Material
Nater Closets To I Fee
3ath Tubs RAIN WATER DRAINAGE
ihowers Size Material
_avatories To IFee
(itchen Sinks WATER SYSTEM
Nsh Washer Size Material
Vaste Disposals Water Fixture Fee
Vash Trays HOUSE GAS PIPING
Vcshinq Machines No. Lines 00 Outlets
Vater Treat. Equip. Size ' Fee
Sinks FEES
)ental Units Fixture Fees
)rinking Fountains Main Drain Fees
'loor Drains StormDrain Fees
Toppers Water Sy
s. Fee
iand Traps Gas Piping Fee
lrinals Surve
Area Drains Permit Fee
Vater Leaders TOTAL FEE
frailer Space INSPECTOR'S REPORT
iwim Pool l Gas Piping
ndirect WastesAp roeq-Q---)
1r well B
iackflow Preventer 1 Partial
urvey Approved --( � �i
B C %Y�snvu"
Rough
TOTAL Approved
B
Finish
A roved Z -7
By I tt