73963 7609 Prosepect Rd
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
,7`76
Date------------- --- ----------------------------- 14�e.. Permit No.--------7-----.......-----------------------
The undersigned hereby makes�appli-ation o'the Plu%bi q Inspector of the City of San Jose
for a permit }o install plumbing ffixturVand j'or pi—pQ list d3Df th. Cis. side.
Exemption from requirement for Sfafof/f California for Contrac+or's License is hereby claimed
by undersigned: as own@r ❑ statement filed ❑
Undersigned attests that his State of California�ntrao}or's License #
is in full force and effect and properly authorizes t`s p���
San Jose City Business License # ,� b
I certify that in the performance of the work for which this permit is issuedrl shell not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER
ADDRESS 7422'
USE OF BUILDING���+
FORM 200-30 IOM 3/67 Signed --. --------------------------
7609 Prospect = Bohart
FIXTURES FIXTURES MAIN DRAIN
Water Heaters / Floor Drains Size Moteriq!
Water Closets HoppersTo To Septic Tank
Bath Tubs Z Sand Traps RAIN WATER DRAINAGE
Showers Urinals Size Material
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 Water Sys. Fee
Dental Units Gas Piping Fee
Drinking Fountains Survey
Permit Fee
TOTAL TOTAL FEE ;j71
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial ,j No. Lines - Outlets Size
Rough42 A Tested and Approved
Finish - G o
v t r By