34959 7595 xATx�>zta00>j nnrvE�pWa���aTf�`�
Building Parmii Confirmed
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date.........C 7----------------------1 19...x"-' Permit No... ......._,5.L.1. ---S.�'--------
The undersigned hereb makes application f he Plumbing Inspector of the City of San Jose
for a permit to install s ip fe Q/o9/tf;eyrerse side.
Exemption from r e o ni { on ors License is hereby claimed
by undersigned: as owner ❑ statement filed���_`
Undersigned attests that his State of Cal ifo 'e Cg t actor's Licon a Ji
is in full force and affect and properly auihori s lice ' _��
San Jose City Business Licensee#y ? - - '(�L�"�
I certify that in the performance of the work for which this permit is issued I shall not employ
any person in eny m nner so as to violate the workmen's compensation laws of California. \1
OWNER �if 'ac i
ADDRESS /��i ��� aV t a•_ c.,;,;�' �. Lot No. 5�
USE OF BUILDING
Signed,,(//J .._r. Sr...-c- ._�rrf....•. ._F,'�r'-` t^-'},
_ 280-401n
7595 9RAT9RRWnnn T)RTVE <VLIFETIME .POOLS
FIXTURES NO. FEE MAIN DRAIN
Water a`
� Size .Material
Water Closets To Fee
Bath Tubs RAIN WATER DRAINAGE
Showers Size Material
Lavatories To IFee
Kitchen Sinks WATER SYSTEM
Diah Washer Size iMaterial
Waste Disposals Water FixtureFee
Wash Trays HOUSE GAS PIPING
Washing Machines No. Lines utlets.
Water Treat. Equip. "" Size .e,� Fee 2,1D
Sinks FEES
Dental Units Fixture Fees
Drinking Fountains Main Drain Fees
Floor Drains Storm Drain Fees
Hoppers Water $ s. Fee
Sand Traps Gas Piping Fee ')o
Urinals Survey
Area Drains Permit Fee
Water Leaders TOTAL FEE
Trailer Space INSPECTOR'S REPORT
Swim Pool Gas Piping
Indirect Wastes Approved
Dr well By \ASAErN�j
3ackflow Preventer Partial '
iurvey APprov
B
Rough
TOTAL Approved
27-1u p s i B
5 z Finish
Approved U.7
B C