9338 1113 Hollyhead Lane
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date....-------------5 ..3U- ------ 19Zt- Permit No..--........373 ....._.------------
The undersigned heryk�y makes pl' t'o to }h Pl urn in Inspector of f City of $an Jose
for a permit to ins}all dlury6y s or o reverse endo.
Exemption from re i r o i4 r recc tor's License is hereby Claimed
by undersigned: as owner ❑ stafement filed ❑ �37 C.36
Undersigned attests that his State of Calif Contractor's License #
is in full force and effect and properly author' es pplic�j'an /
San Jose City Business License # 7
1 certify that in the performance of the work for which this permit is 'issuelf I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER (N E.
ADDRESS ((f 3 (Vag-c y/YEy D IL t Lot No.
USE OF BUILDING � E;S
zeo-3o Signed...�..�.�.e.Y..... -----..
V '
1113 Holl.vhead Lane Ace
FIXTURES NO. FEE MAIN DRAIN
Nater Heaters U SizeMaterial
Nater Closets 11 To lFee
Bath Tubs RAIN WATER DRAINAGE
Showers Size Material
Lavatories To Fee
Kitchen Sinks WATER SYSTEM
)6sh Washer Size Material
Vaste Disposals Water Fixture Fee
Vash Trays HOUSE GASP IPING
Vashin Machines No. Lines Outlets
Vater Treat. Equip. I Size Fee
Sinks FEES
)ental Units Fixture Fees ,co
)rinki ng Fountains Main Drain Fees
=Ioor Drains Storm Drain Fees
Hoppers Water s
S . Fee
Sand Traps Gas Piping Fee
Urinals Surve
Area Drains Permit Fee Z,uo
Nater Leaders TOTAL FEE 1 3.00
frailer Space INSPECTOR'S REPORT
iwim Pool Gas Piping
ndirect Wastes Ap roved
)r well B
lackflow Preventer Partial
urvey Approved
B
Rough
TOTAL /-oo Approved
B
Finish
Approved
B