90458 6611 John Drive
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Dafe---------'---------------2.-'�---------- 19-7�.- Permit No._ ....... -----------
The undersigned hereby eWI. r
'c io lu nspector of the City of San Jose
for a permit {o install plu b' e li the reverse side.
Eramp+ion from requi ori or onfracfor's License is hereby claimed
by undersigned: er ❑ statement filed 13
Undersigned attests that his State of California Contractor's License # 37 9�g
is in full force and effect and properly f+9t+ae�/s g�l�t le I�f
San Jose City Business License # /jam f/h�J�(/�� (/
I certify that in the performance o4rfhe work for which this permit issued I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER L P z zo
ADDRESS 66/ 1 TdyN 'DA Lot No.
USE OF BUILDING e
29g.30 Si gned..'Q`iG<:_�/. ------..` ------- ------------'---...-----..
ArI i .T_a._ _ nr• P1 rsmhi nrt
FIXTURES FIXTURES MAIN DRAIN
Water Heaters Floor Drains Size Material
Water Closets Hoppers To To Septic Tank
Bath Tubs Sand Traps RAIN WATER DRAINAGE
Showers Urinals Size Material
lavatories Area Drains To Curb To Main Sewer
Kitchen Sinks Wafer Leaders WATER SYSTEM
Dish Washers Trailer Space Size Material
Waste Disposals Swim Pool FEES
Wash frays Indirect Wastes Fixture Fee �, d
Washing Machines Drywall Main Drain Fee
Water Treat. Equip. Backflow Preventer Storm Drain Fee
)inks Survey Water Sys. Fee
)ental Units Gas Piping Fee
Drinking Fountains Survey
Permit Fee 2, co
TOTAL TOTAL FEE CT 00
INSPECTOR'S REPORT HOUSE GAS PIPING
Lines Outlets Size
tough Tested and Approved
mish By