29712 14925 JAMtSIUWN UK
qBuilding Permit Confirmed yY
— INot Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBINGand/or GAS PIPING 7PERMIT
/..
Date..... . ...... .B........ 19.7-/-y Permit No............
The undersigned hereb makes li at* o the Plumbing Inspector of the City of San Jose
for a permit to install plm�n�ig'r F. fe�e reverse side.
Exemption from req �/or S al of el e r ontrac+or's reverse
side.
License is hereby claimed
by undersigned. as owner ❑ statement filed ❑ � 7
Undersigned aft: +ha Sfe�' of C or{�iry Cyon+JggGG}}oor's License -'�3'�777s7 /
is in full force and e(Fect airly auf ryflp'{/ ffo➢'
San Jose City Business men
I certify that in the performance of the work for which } is permit is issued 1 shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER DON A /iV,,Q CAI
ADDRESS 145 ✓4MG3 7'-,VA4)A1 QRLot No. y
USE OF BUILDING S I A04 V SAVIA4 A90
Signe /. ...1. .....\s�� ......--..._......
T' ��fe N �if1►liN�•��� /�
280-1foin
1498 JAMFSTOWN DR VAL'S
FIXTURES N0. FEE MAIN DRAIN
Water Heaters — Size Material
Water Closets To Fee
Bath Tubs RAIN WATER DRAINAGE
Showers Size IMaterial
Lavatories To IFee
Kitchen Sinks WATER SYSTEM
Dish Washer Size Material
Waste Disposals Water Fixture Fee
Wash Trays HOUSE GASP IPING
WLoshinci Machines No. Lines ' / Outlets 2.
Water Treat. Equip. Size Fee
Sinks FEES
Dental Units Fixture Fees /411 --
Drinking
4/ —
Drinkin Fountains Main Drain Fees
Floor Drains Storm Drain Fees
Hoppers Water S s. Fee
Sand Traps Gas Piping Fee
Urinals Surve
Area Drains Permit Fee < _
Water Leaders TOTAL FEE
Trailer Space INSPECTOR'S REPORT
Swim Pool — Gas Piping
Indirect Wastes Approved
Dr well B
Backflow Preventer / e Partial
Survey Approved
B
Rough
TOTAL Gj— Approved
/' / 7 '7 B ,
i.OtnC/ Finish
v Approved —/ - Z
B U/