753107577 Lockford Ct q
CITY OF SAN JOSE
Building Permit Confirmed ❑
Not Required' ❑
BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date --- ---...... '-L6----- ............ . — Perm't, No. --
The undersigned here�y�rS i n & d'zp cfor of the City of San Jose
for a permit to ins+all plumbing lures and/or pipes listed on the reverse side.
Exemption from requirement for State of.�ai nia for m+r cor's n eis hereby laimed
by undersigned: as owner � }
Undersigned attests that his State of ifo nia o rac+ors Lice
is in full force and effect and properly authorizes this application. �/ ' /�j(,`
San Jose City Business License #� y f1 `'1 / /
1 certify that in the performance of the work for ich 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
ADDRES
USE OF BUILDING fc2222 l
FORM 280-30 IOM 3/67 Signed ...--- --...-
-- %
7577 Lockf ord Ct
FIXTURES
Ili
FIXTURES
MAIN DRAIN
Water Heaters
Floor Drains
Size
Material
Water 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
Material
Waste Disposals
Swim Pool
FEES
Wash Trays
Indirect Wastes
Fixture Fee
Washing Machines
Drywell
Main Drain Fee
a er reaf. quip. 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 17 Tested and Approved
Fors i.. 9y
Af