86662 1648 Primrose Way
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date------------ ..
-------------r-- -1-- ---- i 97P- Permit No...(15'06-6--- -------`--------
The undersigned hereby makes applicggtiyn to heglumbing Inspector of the City of San Jose
fora permit to install plumbing fivt����i �li � •er e-
y
Exemption from requirement fo�Sfa a ( a f rnia or Confra z iLiaense is hereby claimed
by undersigned: as owner statement filed
Undersigned attests that his State of California Contractor's License ,, 79ory
is in full force and effect and properly authorizes }his appliNt.
San Jose City Business License #'��l ?y �� �
I certify that in the performance of }he work for which this permit's iissued I shell n6 employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER C- oQT C E
ADDRESS _//a_ Pa /P"1/L 05 e W/ Lot No.
USE OF BUILDING 42-
SignedC.UuGf( .....Y�. .
2BOd0 Aug. 69
1648 Primrose Wav Ace Plumbing
FIXTURES FIXTURES MAIN DRAIN
Wafer 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 To Main Sewer
Kitchen Sinks Water Leaders WATER SYSTEM
Dish Washers Trailer Space Size - Material
Waste Disposals Swim Pool FEES
Wash Trays Indirect WastesXLines
Fee , 00
Washing Machines Drywell Drain Fee
Water Treat. Equip. Backflow PreventerDrain Fee
Sinks Survey Sys. Fee
Dental Units ping Fee
Drinking Fountains
Fee 2,00
TOTALTOTAL FEE UO
INSPECTOR'S REPORTHOUSE GAS PIPING
Partial es Outlets Sizeand Approved