73691 1685 Galway
Building Permit Confirmed qfr
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING )PERMIT
Date_..'-----/-- --�----...._----------'---- I . Permit No.--73 =-7-)---------------
The and rsignad hereb makes ap 'ca ' n o the Plumfsin I or of the City of San Jose
for a permit to install p m n r ip i e a ",se side.
Exemption from requiremen r tate Ca o nia for Contractor's License is hareby claimed
by undersigned: as owner ❑ statement filed ❑ qn
Undersigned e!!es}s 1ha} hiss fj'bF Calhi cc #
is in full force and effect end r auf r ca
San Jose City Business Lic Pro
1 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 violate1he workmen's compensation laws of California.
OWNER /lig ll2 C/i���Ja/L/
ADDRESS
USE OF BUILDING
FORM 280-30 10M 3/67 Signed---- -- .-- 1tl ---cG-------------------------------------
1685 Glaway Bohart
FIXTURES FIXTUWRAIN
DRAIN
Water Heaters Floor DrainsMaterial � .
Water Closets HoppersTo Septic Tank
Bath Tubs Sand Traps DRAINAGE
Showers UrinalsMaterial
Lavatories ,_3 Area DrainsTo Main Sewer
Kitchen Sinks Water LeadersSYSTEM
Dish Washers Trailer Space Size Material
te D
Wasisposals Swim Pool FEES
Wash Trays I Indirect Wastes Fixture Fee , <.
Washing Machines Drywell Main Drain Fee �I
Water Treat. Equip. Backflow Preventer Storm Drain Fee
Sinks Survey Water Sys. Fee _ <�
Dental Units Gas Piping Fee _
Drinking Fountains Survey
Permit Fee ��
TOTAL TOTAL FEE f
INSPECTOR'S REPORT HOUSE GAS PIPING
'artial - { No. Lines Outlets Size
Cough /, ��l '6 ,'.�'- ,•.,: .. Tested and Approved i Y