997337415 Plum Blossom
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPIpNG PERMIT
Date------------ —� '� --------- 197.2 Permit ,No.. ----------?-E-73--)--------------
The undersigned hereby pokes application to the Plumbing Inspector of the City of San Jose
fore permit }o�ins}all plumbinjj{uf res end ort pijsas listad)*/�}�hoj�ove a side.
Exemption from regwremlenftiforl3fe of Celif_hi�{or Con{rector's License is hereby claimed
by undersigned:, as -owner ❑ statement filed ❑Z 7 RQG
Undersigned attests that his State of California�Con�actor's License $k ! 00
is in -full force and effect and properly eu}hori� this applica i�4
San Jose City Business License,
I certify that in the performance of the work 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.
OWNER L Q�SCiJf c i(,W.
ADDRESS 7 `' L !4 r -r �3 Z ss o 1- n JL Lot No.
USE OF BUILDING
280 30 Signed R:.�rec..- --:k`r:?=- -------"!'�-o--- ..-----..
7415 Plumblossom Dr. Ace
FIXTURES
FIXTURES
MAIN DRAIN
Water Heaters
/ Floor Drains
Size
Material
Water Closets
Hoppers
To
To Septic Tank
Bath Tubs
Sand Traps
RAIN WATER DRAINAGE
Showers
Urinals
Size
Material
Lavatories
Area Drains
To Curb
I To Main Sewer
Kitchen Sinks
Water Leaders
WATER SYSTEM
Dish Washers
Trailer Space
Size I Material
Waste Disposals
Swim Pool
FEES
Wash Trays
Indirect Wastes
Fixture Fee/ 6t9
Washing Machines
Drywell
Main Drain Fee
Water Treat. Equip.
Backflow Preventer
Storm Drain Fee
Sinks
Survey
Water Sys. Fee
Dental Units
Drinking Fountains
Gas Piping Fee
Survey
TOTALTOTAL
Permit Fee , pp
FEE •po
INSPECTOR'S REPORT
Partial
Rough '•
Finish G/ —2� %v
HOUSE GAS PIPING
No. Lines Outlets Size
Tested and Approved
By