91532 7565 Heatherwood
/k i Building Permit Confirmed ❑
2 V Not Required Q
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date-------------------.%..'----�---- --- 19.71. Permit No--------------q.l.�- v------------
The undersigned hereby m es applicati }o the Plur ¢in Ins or of the City of San Jose
for a permit }o install plumb' g i s / pe is d r arse side.
Exemption from require e e a' r is o C r or's License is hereby claimed
by undersigned: es caner ❑ C ,,, r statement ailed ❑
Undersigned aft
ests that his 5 ate of Califorr o f lice
License # 2` 7
is in full force and effect and properly authorize 4h'4Ef�o'p/lice}io N San Jose Jose City Business License
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 ZA)ci G
ADDRESS 7S6S F/EATyr2tvcot> DA Lot No.
USE OF BUILDING
28030 Signed_.1a---�.`. °"--------
1. .. rc.................
7565 Heatherwood Ace Plumbing Service
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 To Main Sewer
Kitchen Sinks Water Leaders WATER SYSTEM
Dish Washers _J Trailer Space Size I Material
Waste Disposals Swim Pool FEES
Wash Trays Indirect Wastes Fixture Fee
Washing Machines Drywell Main Drain Fee
Water Treat. Equip. Backflow Prevenfer Storm Drain Fee
finks Survey Water Sys. Fee
)ental Units Gas Piping Fee
Drinking Fountains I Survey
Permit Fee Z. ua
TOTAL TOTAL FEE 3•��
INSPECTOR'S REPORT HOUSE GAS PIPING
No. lines Outlets Size
lough * Tested and Approved
vmsh By