31008 7572 HOLLANDERY PL
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE IT BUILDING DEPARTMENT
APPLICATION FOR PLUMBINGandand/or GAS PIPING/ PERMIT
Dat e...... ...`�..._............... 19.'..-l. Permit No.....---- /dOS
.. .._......--......--------
Tho undersigned hereWmen
r n th um g�sp9999c1or of the Ci}y of San Jose
fora permit to install pli -es �ftip�raversa side.
Exemption from requitCa ornia for Cor/acfor's License is her by claimedby undersigned: er ❑ statement filed
Undersigned attests that his State ofCa or&—Confjjjjc}or's 'cei
is in full force and effect and properly ai} h's �qll�
San Jose City Business License $k /
I certify that in the performance of the or for which this permit s dued I shall not employ
any person in any manner as to/io�la fe the_workmen's compensation laws of California.
OWNER
ADDRESS of No.
r
USE OF BUILDING
Signed --- ----- ' gyp] - --.....
7572 Hnl I ANIIFRY PI a' �SZ ��l�C�/ I lFiN 7�-�F�lA
FIXTURES NO. FEE MAIN DRAIN
Water Heaters 2r- Size Material
Water Closets To Fee
Bath Tu6s RAIN WATER DRAINAGE
Showers Size Material
Lavatories To Fee
Itchen Sinks WATER SYSTEM
Dish Washer Size Material
Waste Disposals lWater Fixture Fee
Wash Trays HOUSE GASP IPING
Washing Machines No. Lines - Outlets
Water Treat. Equip. Size IFee
Sinks FEES
Dental Units Fixture Fees
Drinking Fountains Main Drain Fees
Floor Drains Storm Drain Fees
HoppersWater S s. Fee
Sand Traps Gas Piping Fee
Urinals I Survey7
Area Droins Permit Fee
Water Leaders TOTAL FEE
Trailer Space INSPECTOR'S REPORT
Swim Pool Gas Piping
Indirect Wastes Approved
Dr well B
Backflow Preventer Partial
Survey Approved
B
Rough
TOTAL Approved
B
Finish
Approve /-
B
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