35478 7536 HOLLANDERRY PL
ue Awe° T���r
Building Permit Confirmed Lj
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR
PLUMBING and/or GAS PIPING PERMITDate----- -- ... .._ ...-. --------- 19.26 Permit No.-------3..-5-Y.7-6-.-_.......
Tho++ ndersig ned Toby mak ppl' at' to the P umbing I,nAnec}or of iha City of Sen Jose
for a pEr'nl to ins p in {ix or p s d y�fffer reverse side.
Exam pfion fro rI�q or a alt is r ra ctor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned aHests that his tate of Cal iforn' Cenhac or's Lic nso
is in full force end effect and p p authorix i' a fi
San Jose City Business Lic
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
ADDRESS • 3 �/1et��/c'�_�/ Lot No.
USE OF BUILDING
Signediy---------------
�_`l1 2
7[;V; Hnl I ANDFRRY PI BILL6 PL&80-401n
FIXTURES NO. FEEI IN DRAIN
Water Heaters Size Material
Water Closets i ee '—
Bath Tubs RAIN WATER DRAINAGE
Showers / Size Material
Lavatories To IFee
Kitchen Sinks r V/ATER SYSTEM
Dish Washer Size S Material
Waste Disposals Water Fixture Fee
Wash Trays HOUSE GAS PIPING
Washing Machines No. Lines Outlets
Water Treat. Equip. Size
Sinks FEES
Dental Units Fixture Fees �S v
Drinking Fountains Main Drain Fees
Floor Drains Storm Drain Fees
Hoppers Water Sys. Fee
Sand Traps Gas Piping Fee
Urinals Survey
Area Drains Permit Fee
Water Leaders TOTAL FEE I4 `
Trailer Space INSPECTOR'S REPORT
Swim Pool Gas Piping
Indirect Wastes Approved
Dr well B
Backflow Preventer Partial
Survey Approved
B
F{aogh
TOTAL I App raved
B
Finish
Approved C,
B