94196 7738 Huntridge Dr
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICAT ONN FOR PLUMBING and/or GAS PIPING PERMIT
/PERMIT
Date- ---/""--------'----......._ 19`..../fermi+ No .�.--L---"`---------------
T u ersi ned hereby makes application to the Plumbing Inspector of the City of San Jose
for a pa it to
ins} p f- ted on the reverse side.
Exemption from i is for Contractor's License is hereby claimed
by undersigned: as owner ❑ statemenf filed f,]�r_ C�
Undersigned attests the} his ate of California Contractor's License
is in full force and effect and pr p I -
th
San Jose City Business Licen �h tl is fX/
1 certify that in the performance of the workk for whicpermit is issued I shall not employ
any person in any manner so a violate t e+workmen's com ensa}iorn laws of California.
OWNER
ADDRESSLeeLot No.
USE OF BUILDING
280-30 Signed.. -
77QR Usmtri Aso Avo F nrhi 11 1P1 by
FIXTURES FIXTURESMRAINWATER
IN
Water Heaters Floor Drains terial
Water Closets Hoppers Septic Tank
Bath Tubs Sand Traps AINAGE
Showers Urinals terial
Lavatories Area Drains Main Sewer
Kitchen Sinks Water LeadersEM
Dish Washers Trailer Space Size I Material
Waste Disposals jSwim Pool FEES
Wash Trays Indirect Wastes- Fixture Fee
Washing Machines Drywell Main Drain Fee
Water Treat. Equip. Backflow Preventer Storm Drain Fee /'-
Sinks Survey Water Sys. Fee
Dental Units Gas Piping Fee
Drinking Fountains Survey
Permit Fee G^ C..
TOTAL TOTAL FEE 3 -
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial No. Lines Outlets Size
Rough Tested and Approve —
°imsh By
,HWS_