74949 8187 Presidio
Building Permit Confirmed
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Da#el!/�/�.fl -- CP......--------..... 12`.26... Pernni# No-------7- ------
The undo signed hereby ekes appliceli 4o he PI u Bing Inspecfop of the City of S Jose
he r� gq
fora permit to install plum �3 a d�7orRpr{p� 73
�fod opAif�warsc side.
Exemption from requirement for'Sta4 atit-0fornie for Connectors License is hereby claimed
by undersigned: As owner ❑ statement filed ❑,
Undersigned attests that his State of California Contractor's License # — V-3
is in full force and effect and properly euthorixei'�tffis application ��
San Jose City Business License # �/K " 2,gyey'� >r
I certify that in the performance of th�fo�this permit is issued I -shall not employ
any person in any manner ;sy as t ! m
ate the woen's compensation laws of California.
OWNER �J
ADDRESS
USE OF BUILDING
FORM 280-30 10M 1/68 Signed ..:. ............. .+..... .a'�'^..:""C.r------ -. f...-...-.
8187 Presidio T&'
FIXTURES FIXTURES MAIN DRAIN
Wafer Heaters Floor Drains Size Material
..Wafer Closets Hoppers To ;To:Septic Tank
Bath Tubs Sand Traps RAIN WATER.DRAINAGE
Showers Urinals Size Mawial
Lavatories - Area Drains To Curb -I 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
-Water Treat. Equip. Backflow Preventer / Storm Drain Fee
Sinks Survey Wafer Sys. Fee
Dental Units Gas Piping Fee
-
Drinking Fountains Survey
Permit Fee , O
TOTAL TOTAL FEE 3U
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial No. Lines Outlets IZ Size
Rough Tested and Approved
Finish — / By