91380 7385 Rainbow
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date-... 2....... ------------------------ 19,7V- Permit No. C, ��------------
The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose
for a permit to install plumbing fixtures and/or pipes listed on the reverse side.
Exemption from requirement for State of California for Contractor's License 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 aufho fixes f is pplice}}jion.
San Jose City Business License # �7' � ��
I certify that in the performance of the work for which this permit is issued I shall not employ
any person inl any m arsper so as to vioa the workmen's compensation laws of California.
OWNER
ADDRESS 5� ! SGB' Lot No.
USE OF BUILDING � ®
� lll!?.0-i/
280.30 Signed--- ----------� t ------ -------------
7385 Rainbow P Plumbing
FIXTURES FIXTURES MAIN DRAIN
Water Heaters Floor Drains Size Material
Water Closets Hoppers To To Septic Tank
Bath Tubs S Sand Traps RAIN WATER DRAINAGE
Showers Urinals Size Material
Lavatories — Area-Drains To j To Main Sewer
Kitchen Sinks s Water Leaders WATER SYSTEM
Dish Washers Trailer SpaceSize / Material 41
Waste Disposals Swim Pool FEES
Wash Trays Indirect Wastes Fixture Fee
Washing Machines Main Drain Fee
Drywell
.p ,
Water Treat. Equip. _ Backflow Preventer Storm Drain Fee
Sinks Survey Water Sys. Fee ,p O
Dental Units Gas Piping Fee
Drinking Fountains Survey
Permit Fee �' • d 0
TOTAL TOTAL FEE
INSPECTOR'S REPORTHOUSE GAS PIPING
Partial No. Lines Outlets Sized
Rough. r / , Tested and Approved
Finish