92846 937 Liberty Court
Building Permit Confirmed
Not Required
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
—2 3--- ---.. 19..7.(. Permit No.------------ �
Date..... --- - --------
i
The undersigned her y }' o u n actor o4 }he City of San Jose
for a permit }o install i e e e e o e re.erse side.
Exemption from requirame for State of California for Confraclor's License is hereby claimed
by undersigned: as owner ❑ statement filed R
Undersigned attests that his State of C rn' .£on4rec
is in full force and effect and properly e`uiL r' s fii app
San Jose City Business License # _( " 7 — c
1 certify that in }he performance of the work for which this permit is issued I shall not employ
any person in any manner so as to violate the workmon's compensation laws of California.
OWNER G ID
ADDRESS '`J 3 r7 L>6c .a r / L° o,a i Lot No. 2 ;Z'
USE OF BUILDING 12
j 5 r7 S 5'n'✓e..i'S' cee —�
937 Liberty Court Blue ChamnaaneB2' Xk" ems
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 Trays Indirect Wastes Fixture Feed d,
Washing Machines Drywell _ Main Drain Fee.,
Water Treat. Equip. Backflow Pre enter Storm Drain Fee
Sinks Survey Water Sys. Fee
Dental Units Gas Piping Fee 6
Drinking Fountains Survey
Permit Fee
TOTAL TOTAL FEE
INSPECTOR'SiR P RT P HOUSE GAS PIPING
U�
Partial No. Lines" _
( Outlets / Size
Rough 42 Tested and p rov d
Finish — -7 By
Ii