39692 y.7552 HEATHERWOOD'l`t. PHONE 2]� 458+
``a` �- Building Permit.Confirmed ❑,
,Not.Required' ..�. ''❑
?y `gyp i,•- 'R` � " _ �.
' CITY OF-SAN JOSE yyrlr BUILDING DEPARTMENT
APPLICATION FOR PLUMBING. and/or GAS PIPING PERMIT
Date. -..-._. .... .. 19//.: Permit No ) �..:.-.9� -
3 Tha undersigned here kcs applicafio to the Plgmbing Ins or of the city,of San Jose
pr i for a perm if, to install p m a r p s st o •erse side.
&em ptioo from req o{ orn a or on fors License is hereby claimed ,
. by vndersig ned: as owner ❑ statement (fled ��
Undersigned- aflests #hat s Stateo aifomia Contractor's License ,
.is'm'full force and effect and properly s his a�P I�
Fan 'Jose City Business License"#
e
"❑ 1-certify that in the performance of the work'for whinot mpch this permit is ssu d I shall loy,
any person. -
'!
OWNER
ADDRESS Lo+ o.
N "�
k . ' USE OF BUILDING •^ ..
Al
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ign d .
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7.552..HLATHE ROD, ACE
FIXTURES NO. FEEI MAIN DRAIN
Water Heaters Size Material
Water Closets To Fee
Bath Tubs RAINWATER"-DRAINAGE
Showers SizeL IMaterial
Lavatories I To IFee
Kitchen Sinks WATER SY$TEM
-
D' -W is er Size IMaterial
Waste Disposals Water Fixture Fee
Wash Trays HOUSE GAS PIPING
WashingMachines No. Lines Outlets
Water Treat. Equip. Size Fee
Sinks FEES'
Dental Units Fixture Fees
Drinking Fountains Main Drain Fees
Rloor Drains Storm Drain Fees
Hoppers.. - Water Sys. Fee
Sand Traps Gas PipingFee
Urinals "Surve
Area Drains Permit. Fee o�
Water Leaders TOTAL FEE 146 -c�w
Trailer Space INSPECTOR'S REPORT -
Swim Pool Gas Piping
Indirect Wastes Approved
Drywall B
3ackflow Preventer 'Partial
iurvey I Approved -
B
Rough`".
TOTAL Approved
.B 'Af
Finish _
Approved
B