4541 7819 Lilac Ct.
Building Permit Confirmed ❑
1 Not Required -{9
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING.and/or GAS PIPING PERMIT PE�RMIT
Date-----7---4------.----------------._... 19-/35 Permit No.....---------------Z/ _ .7/.1/.......
The undersigned hereby makes applicefion o the PI umbi Inspector of the City of San Jose
for a permit to i al p an ilti' is the reverse side.
Esamption o nt o a' or on
irac#or's License is hereby claimed
by undersigned: as owner ❑ s}atemen4 file�7{� ❑
Undersigned attests chat his St to of California Contractor's License #`'-3L
is in full force and effect and pro ly �ies this li figpA
San Jose City Business Licen b�� d�
Icertify that in the performance of the work f r ich this permit is i� I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNERB/—i-- U A'K/
ADDRESS 78�1r u1 9�C° /' Lot No.
USE OF BUILDING 10-ea44 WC-
zeoao
Signed - -- "-'-'---' '-----------------------
�-------.....
7819 Lilac
Fannon'
FIXTURES FIXTURES MAIN DRAIN
Water Heaters / Floor Drains Size Material
Wafer Closets Hoppers To I 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 I Material
Waste Disposals Swim Pool . FEES
Wash Trays � Indirect Wastes Fixture Fee -
Washing Machines Drywell Main Drain Fee
Water Treat. Equip. Backflow Preventer Storm Drain Fee
Sinks - Survey Wafer Sys. Fee
Dental Units Gas Piping Fee -
Drinking Fountains Survey
Permit Fee x„an
TOTAL TOTAL FEE •00.
INSPECTOR'S REPORT HOUSE GAS PIPING
PaAial No. Lines
Rough - Outlets Size
Tested and Approved
Finish B
Y