33866 8095 PARK VILLA C1R
C Building Permit Confirmed ❑ .
Not Required a
CITY OF SAN JOSE -BUILDING DEPAR ,ENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERM\ITA,' r'
Date------- -Z -------------- I�0. Permit No...:..7...�. f"
The undersigned harebf�,nekb: pl{e N"on�1♦?�ih�Pl�mb�g Inspector of the City of San Jose
for a permit to install plsa�rr 6sn`gr�/fis}ures an`dror�pipai li(1'ed on/i�e reverse side.
Esempfion from requuementLfor State of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ a. statement filed ❑
Undersigned attests that his State of California Contract",
is in full'force and effect and properly authori:esffhiss'-.% ice t" i!W
San Jose City Business License # 5��— 9
I certify that in the performanceof�ork 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. S1Q
OWNER
ADDRESS �G� / �� �G� 0, Y/a C ('(z Lot No.
USE OF BUILDING
Signe .........__.......---�.//...... i`.-- -- ------------
�" /' S P -401n
Rngc; PARK VTI I A CTR S. A. M. S PLBG
FIXTURES NO. FEE MAIN DRAIN
Nater Heaters SizeMaterial
Nater Closets To lFee
3ath Tu6s RAIN WATER DRAINAGE
Showers Size Material
_avatories To iFee
(itchen Sinks WATER SYSTEM
)'sh Washer SizeMaterial
Vaste Disposals Water Fixture Fee
Vash Trays HOUSE GAS PIPING
Vashing Machines No. Line s /
@ l
Vater Treat. Equip. Size lree I c�3
Sinks FEES
)ental Units Fixture Fees
)rinkinq Fountains Main Drain Fees
=Ioor Drains Storm Drain Fees
rloppers Water Sys. Fee
Sand Traps Gas Piping Fee ;j O
Urinals Survey
Area Drains Permit Fee O J
Nater Leaders TOTAL FEE
frailer Space INSPECTOR'S REPORT
iwim Pool Gas Piping
ndirect Wastes Approve —2
)r well B
Sackflow Preventer Partial
urvey Approved
B
Rough
TOTAL Approved
B
Finish
Approved
B