739647549 Prospect Rd
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date......-- .-------------_....--'-----.. 19 .e%� Permit No..------- �?l`G `/...........
The undersigned hereby makes ppplicaa ionto She PI_umbin lnspeetor,�fhe City of San Jose
.fore permit to install plumbing iiziuSes and>/o, papas listed do the ievarse s'rile.
Exemption from requirement ifo�St��f°Californ fo �Codi�a�or's Lcense is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests that his State of California Contractor's License #
is in full force and effect and properly authorizes this�apppliiccationtr �-�� /� V
San Jose City Business License # %��'7"� r/ /. MAZ- ^'�
I certify that in the performance of the work for whicrthis'permit is issued 1 shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
7
OWNER / l?d�ti•
ADDRESS
USE OF B
FORM 280-30 1G,„ „.,
7549 Prospelj.t d Bohart
FIXTURES FIXTURES MAIN DRAIN
Water Heaters / Floor Drains Size Material,
Wafer Closets Hoppers To To Septic Tank
Bath Tubs / Sand Traps RXIN WATER DRAINAGE
Showers
/
Urinals
Size
Material
ries
Area Drains
To Curb
To Main Sewer
Sinks
/
Water Leaders
WATER SYSTEM
_ashers
Trailer Space
Size
Material
Disposals
Is
Swim Pool
-
FEES
Trays
g Machines
Equip.
Indirect Wastes
Backflow Preventer
Fixture Fee
raFeeTreat.
Storm Drain Fee
Sinks
Survey
Water Sys. Fee
unnxmg rournams i I Survey
Permit Fee
le TOTALTOTAL FEE
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial -� No. Lines i Outlets ..41— Size