82469 7611 Hollanderry
Building Permit Confirmed ❑
Not Required LL--
CITY
iCITY OF SAN JOSE BUILDING DEPARTMENT
AP LICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date. .... . .----aC--9 I�f. Permit No ------7`--y6-Sl...........
o dersi ad herlsb��J�'mmaakkee�'fsis application to the�Plumbing Inspector of the City of San Jose
for
mi! to insiall/oG / / e s n the reverse side.
Eramption from r 9�r!W orr��ontrecfor's License is hereby claimed
by undersigned: as owner ❑ statement Filed
Undersigned attests that his Stale of alio ie Co a r ice
is in full force and effect and properly IN
San 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 0 2
ADDRESS /
USE OF BUILDING n LO I N ®•
S
. �dQ �c�o�Z /
280.30 ro-ea igne .— — ------ - —`. ---- -....
7611 Hollanderry Langmans
FIXTURES FIXTURES r MAIN DRAIN
Wafer Heaters Floor Drains Size Material
Water Closets Hoppers To I 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 Trailer Space Size Material
Waste Disposals Swim Pool FEES
Wash Trays Indirect Wastes Fixtur45ys.
Washing Machines Drywell Main Fee •-r_
Wafer Trea}. Equip. Backflow Preventer Storm Fee
Sinks Survey WaferFee
)ental Units Gas Piping Fee
Drinking Fountains Survey
Permit Fee
TOTAL TOTAL FEE .�—
INSPECTOR'S REPORT HOUSE GAS PIPING
'artial No. Lines Outlets Size
tough Tested and Approved
'inish 6 - - By