87789 8051 Presidio Drive
Building Permit Confirmed ❑`
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS
APPLIC PIPING PERMIT/ p�-�^7 Q
Date------- -- «R.......------------. M-�O Permit No.------?77_-`�.�-----------------
The unders hereby m9k�ttp�r ss y�.,he Pluabin Inspector of the City of San Jose '
for a permit to install plum bing�fiNure an�forppesVi/te: an�he�reverse side.
Exemption from requirement for 5 ate of\Californi. tar Contractor's License is hereby claimed
by undersigned: as owner ;0-1., statement filed ❑
Undersigned attests that his State of California Contractor's License #
is in full force and effect and properly authorizes thi4:a ppli tion:
San Jose City Business License # � ,� �7y�kr
I certify that in the performance of the work for which this permit is issued I shall not employ
any person in any Ver so es to violet fh orkmen's compensation laws of California.
OWNER i. ten+
ADDRESS OS \ Ltdt Qi.+� y Lot No.
USE OF BUILDING
280.30 Aug. 69 Signed
8051 Presidio Drivel Hunt
FIXTURES FIXTURES MAIN DRAIN
Water Heaters' Floor Drains Size Material
Water Closets Hoppers To To Septic Tank
Bath Tubs Sand Traps RAINWATER 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
Washing Machines Drywell Main Drain Fee
Wafer Treat. Equip. Backflow Preventer Storm Drain Fee
Sinks Survey Water Sys. Fee
Dental Units Gas Piping Fee Q
Drinking Fountains Survey
Permit Fee 6
TOTAL TOTAL FEE /
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial No. Lines Outlets Size/ Z
Rough Tested and Approved) 17 r
Finish By �=d1...4 ..J