72533 7639 Prospect
Building Permit Confirmed
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date-- ------- ----------------- 19,/,..2 Permit No.--------------/.. .SJ L—'— `.
The undersigned hop-lay makes ap Ii I* n +o the Plumbing In ec+or of the Ci}y of San Jose
fora permit to instal plu i r ip gN�rev¢rsa side.
Exemption from a r rector's License is hereby claimed
by undersigned: as owner ❑ sfafament filed ❑
Undersigned attests that his State of Calif nia Coniracfor's License #' 77 3o L�/
is in full force and effect and properly author' an - !. y
San Jose City Business License # / �� T/ 7
I certify that in the performance of the work for which this permit is issued I shall not employ
any person in any manna s to viola+ a workmen's compensation laws of California.
OWNER
ADDRESS
USE OF BUILDING
FORM 280-30 IOM 3/67 I Signed------ ------------------- -..._------------- -
7639 ProspectCr wn`�'�`�
FIXTURES FIXTURES MAIN DRAIN
Water Heaters Floor Drains Size Material
Wafer—Closets (-, _T
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 Wastes Fixture Fee G
Washing Machines Drywell Main Drain Fee
Wafer Treat. Equip. Backflow Preventer Storm Drain Fee
Sinks Survey Wafer 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 / �7�L, (���j ^ Tested and Approved
Finish — — By