95928 8061 Park Villa Circle
Building Permit Confirmed ❑
Not Required I I
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date ... ...----....---------------- 19.7 .. Permi# No ---...---- .. ........-----
The undersigned hereby malesapplic tion f ,ge Plumbing In p ctor of the City of San Jose
fore permit to install plumbing fntur s and`�or pipesYfist d r reverse side.
s e �ir�/j� .ri oe`ib
Esomption from require�t�oy�SFaie of Ceh(orma for Contractor's License is hereby claimed
by undersigned: as o4rer 0 statement filed
Undersigned attests that his State of California Contractor's License #
is in full force and effect and properly authorizesthn aaj�ica�h.
San Jose City Business License #-4(. !L // �Ys--p(/
n i�—�
I certify that in the performance of the work for which this permit is issued I shall not employ
any person iany manner so as to violate the workmen's compensation laws of California.
OWNER
ADDRESS ��� � �/ �l/�/ y// Lot No.&P
USE OF BUILDING
a�E 1 AlFWAPJ
_IIVG, INC.
280.30 SiC) d........................._ .....
�L17�— fr
8061 Park Villa Circle "maral Plumbing
FIXTURES FIXTURES MAIN DRAIN
Water Heaters Floor Drains Size ' Materi
Water Closets Hoppers I To Se is 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 WashersTrailer Space Size /' Materia
Waste Disposals Swim Pool FEES
Wash Trays Indirect Wastes Fixture Fee
Washing MachinesDrywell Main Drain Fee �J
Water Treat. Equip. Backflow Preventer Storm Drain Fee
inks ISurvey Water Sys. Fee
)ental Units Gas Piping Fee
Drinking Fountains Survey
Permit Fee 2,�Q
TOTAL TOTAL FEE
INSPECTOR'S REPORT HOUSE GAS PIPING
'artial ,Z - - L T No. Lines Outlets 57 Size
lough G 7 a_ ?77A00, Tested and Approved = 1..72
'finish By
T- /*72-