92959 I 919 New Haven Court
. Building Permif Conlirmed�
i . No! Raquired ❑ .
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATIOI� FOR PLUMBING and/or GAS PIPING PERMIT �
Dafe.------....-�-1(.�.------...--------. 19�./ Permit No.----9a-�'- �y--�--...... .
The undersigned hereby �wkes epEyIic�aA}i�' �fo�th$ P�m�ing�nsprc �of the Ci4y oi Sen Jose �
for a permi} }o insfall plum�g�{qa�� �,$''�,/�!r/��pes�tst�ad �of,�h re erse side.
ERemption from raquiremenf for�ata of GPaliforni fOr �ort ra�o� License is hereby elaimad
by, undersigned: as wner ❑ ' dahement iiled ❑ "� '�n/
Undersigned at4esfs iha} his $4e}a of Cali{prnie Confrocfor's License # L�C� �7
is in full force.and effac} and p�operly aut or_ ii�e:�f i�pop�% i6 ��pr� �j /// /�
Sen Jose City Busineu Licanso #� �� ��`V '�� .
I ce�tify }ha4 in }ho performance of the �.'ark For which 4his permi} i�hell no} employ
eny person �n any menn¢r so/a's'fo nol e fha workmen's companse}ion laws of Celi(ornie.
OWNER vV P��
' �� �..�- ,{� Lo4 No.
l/ ADDRESS ���%/ P W /��P�. Cy .
. � r/ -.
USE OF BUILDING �a k �/N
y� / fPy vi-��
Signed. �i/-r �� •.- ---- .....--.......
/..___ ' ... - �
280-30 /�
919 Nea Haven Cout
'" ��hils Plu ina
FIXTURES FIXTURES MAIN�DRAIN
' Niafer Heaters � Floor Drains Size Maferial
Wafer Closefs Hoppers � To To Septic Tank
i Bath Tubs ' / Sand 7raps RAIN WATER DRAINAGE
Showers Urinals Size Maferial
Lavafories Area Drains To Curb To Main Sewer
Kitche� Sinks '/ Water Leaders WAIER SYSTEM
Dish Washers Trailer Space � Size Maferial
Wasfe Disposals Swim Pool FEES
Wash Trays Indirect Wosfes Fixfure Fee g, � rj
Washing Machines Drywell � � Main Drain Fee f
Wafer Treaf. Equip. � . Backflow Preventer Storm Drain Fee
Sinks Survey Wafer Sys. Fee ' "
Denfal Unifs Gas Piping Fee �s`� .
Drinking Fountains ` Survey
, � Permif Fee a, p �
70TA1 • �TOTAL FEE ,2 ,
INSPECiOR'S REPORT � HOUSE GAS PIPING
PaMial - No. lines
Ro�9h / Ouflefs Size
�Tesfed and Appro d - Q .�
Finish,/-n� 1—_7� — [ � Y/KOFFICE By
�'�' .L�w. t .