99052 8117 Presido
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date ' r
-="- .................................... 197_y Permit No.....�-3
C/J. 2........ ...............
The undersigned 'herebympk syap:li�gfiip o the PIumbI Inspector of the City of San Jose
for a perms} to install p�mbiFq�fiefui e�/or�pl�ak If, on the reverse side.
Exemption from' require/mlfeof fo�S}a� of CayliforFia for Gonirecfor'z License is hereby claimed
by,undersigned: as owner ❑ statement filed L]Undersigned attests that his State of California Contractor's License # 3 COI'"
is in full force and effect and properly au{florizeiathijAlicaliong:'�
San Jose'City Business License # �r�f /V' •�+
1 certify that in the performance of fhe work for which this permit is issued I shall not employ
any person in any manner so as to viiolate }h wor man's compensa}ion laws of California.
OWNER
S^�C -��
ADDRESS ZZ 7 404/0 -PA I C Lot No.
USE OF BUILDING ' /�
100.30 Signed(S�-`. .-'- --------... _-------....------_.------..
8117 Presido Drive ��GTermi�ntrol
FIXTURES FIXTURES MAIN DRAIN
Water Heaters Flnor 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 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
Washing Machines Drywell 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 '
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial No. Lines
Outlets Size
Rough Tested and Approved
By