95092 7851 Orion Lane rG�
I Building Permit Confirmed ❑
Not Required
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
1'S�
Date--...... - .....���. ��^ 19-71 Permit Permit No.../ -Z ....................
The undersigned hereby makes application to thel Plumbing Inspector of the City of San Jose
for a permit to install plumbing fixtures and/or pipes listed on the reverse side.
Exemption from requirement for State of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ . statement filed ❑ .
Undersigned attests that his State of California Contractor's License #1375'Oj'
is in full force and effect and properly authorize., ��/eppc41 �on.
San Jose City Business License # O/
I certify that in the performance of the work for 1which 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 k/NLLiw;.
ADDRESS 7kS/ 021 oa L Lot No.
USE OF BUILDING C' r (�
Signed A .S-{���i� ._..lYf_c..cx%�--//-- L�'--
2eo-3o
7851 Orion Lane Ace Plumhina
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 r pp
Washing Machines Drywall -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 e10
INSPECTOR'S REPORT HOUSE GAS PIPING
P°A'al No. Lines Outlets Size
Rough Tested and Approved
By