87346 7534 Lockfordc Court
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATIO FOR PLUMBING and/or GAS PIPING PERMIT
�f -----------------------�-------------------------
Th.
Date � � ... - - 19�r�. Permi# No. - -...... .........
The undersigned hereby p• i PI ng ns of the City of San Jose
fore permit to install
plum it
as
! a r arse side.
Exemption from requirement fo fate of alifornie for Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑ �� s
Undersigned attests that his State of Calif n y��'�ir�Rrr
is in full force and effect and properly auihori a RIYo PlSan Jose City Business License # ��
I certify the} 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 (�
ADDRESS 7 �J3T D G C p r -
USE OF BUILDINGAL
Signed.. V ^'-`-`--------------- ------------- -------------
FORM 280-30 IOM 3/672575 ,3 iL-LD ROAD
7534 Lockford Courrt OUJ CITY, wiFn -PPu-b'ina
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 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 Water Sys. Fee
Dental Units Gas Piping Fee
Drinking Fountains Survey
Permit Fee
TOTAL TOTAL FEE
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial ) No. Lines Outlets Size
Rough a—_ Tested and Approved
Finish i i f czo
-By