9738 7724 Himtridge
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE C> BUILDING DEPARTMENT
APPLICATION FOR PLUMING and/or GAS PIPING PERMIT
Date------_ _----------------------------------- 19Z(�. Permit No.----(�-L-
Z `�-----------------------
The undersigned hereby ekes a lic 4io o the Pluming I ector of the City of San Jose
for a permit to install f' ur pi t i e reverse side.
Exemption from reqpf e f i n o rector's License is hereby claimed
by undersigned: as owner ❑ statement filed
Undersigned attests than his State 'for %Con r or' L' arse r"
is in full force and affect and properly au o x his
San Jose City Business License
I certify that in the performance of the work for which this permit is-issued I.sh.11 not employ
any person in any manner so as fo elate th �orkrrfE com penseiion laws of California.
OWNER (//
ADDRESS ;7Z U/- R-el G Lot No.
USE OF BUILDING 0-
280-30(9-73) Signed ---- -- -- - --�---' -'--------- ...................
r+»"u Rll„+Ti Ac,a Kato Plba.
FIXTURES NO. FEE MAIN DRAIN
Nater Heaters I Size IMaterial
Nater Closets I To I Fee
3ath Tubs RAIN WATER DRAINAGE
Showers SizeMaterial
_avatories To Fee
(itchen Sinks WATER SYSTEM
)6sh Washer / Size Material
Vaste Disposals Water Fixture Fee
Vash Trays HOUSE GAS PIPING
Vashing Machines No. Lines Outlets
Vater Treat. Equip. I Size IFee
Sinks FEES
)ental Units Fixture Fees
)rinking Fountains Main Drain Fees
=Ioor Drains Storm Drain Fees
coppersWater 1a;. Fee
Sand Traps Gas Piping Fee
Urinals Survey
Area Drains Permit Fee Ci OV
Nater Leaders TOTAL FEE --
frailer Space INSPECTOR'S REPORT
Swim Pool Gas Piping
ndirect Wastes Ap roved
)r well B
iackflow Preventer Partial
urvey Approved
B
Rough
TOTAL Approved
B
Finish
Approved •1{,_
B