85996 7733 Lilac Way
Building Permit Confirmed ,❑
Not Required l(1/
CITY OF SAN JOSE BUILDING DEPARTMENT
-APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date- - -- - --......�.7_. 19.70 Permif No..........-- J... .a..
The undersigned r by kes ap�licafio to�ihe Plu ng Inspector of the City of San Jose
for a permit to in I d ai o �9a�j� a on the reverse side.
Esempfion fro ra u enf Sta e f i ,ie�Contracfor's License is hereby claimed
by undersigned: as owner ❑ statement filed
Undersigned a+lasts that his State of C Confrj�J.i 0
is in full force and effect and properly aut sTis apyRURi�nV
San Jose City Business License # / _0
I W
I certify that in the performance of the work for which this permit is issued I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER C(N L H V ,
ADDRESS -?7 -3 3 1,/ L A c Cu A I/ Lo+ No.
USE OF BUILDING fit / ` -
. C
Signed..a- L.e. c V
20040 Aug. 69
7731 Lilac Wav Ace
FIXTURES FIXTURES MAIN DRAIN
Water Heaters Floor Drains Size Material
Wafer 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 Water Leaders WATER SYSTEM
Dish Washers Trailer Space Size Material
Waste Disposals Swim Pool FEES
Wash Trays Indirect Wastes Fixture Fee �, 00
IDental
Machines - Drywell Main Drain Fee
at. Equip. Backflow Preventer Storm Drain Fee
Survey Water Sys. Fee
itsGas Piping Fee
ountains Survey
Permit Fee Z. ,o
TOTAL TOTAL FEE
INSPECTOR'S REPORT HOUSE GAS PIPING
Parka) No. Lines Outlets Size
Rough / Tested and Approved
Finish = O By