74656 7656 Raihbow. /
Building Permit Confirmed F f
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS
rP�IPIING PERMIT
Date--April._15.............-----....-... 1968-. Perrni+ No..------ /-'( G s6
---------------------
The undersigned hero makes applica+ion to the Plumbing In for of the City of San Jose
for a permit to install mb' g i asQ/ averse side.
Exemption from re u' s'(c���' '�''f' ac#or's License is hereby claimed
by undersigned: s owner LJ statement filed ❑ 216217
Undersigned aites}s Ihaf hi State o4 Cali{ornippNConfreclor's License #—r—
is in full force and effect and properly authorixei/lhjt /Ice}i A, 9
San Jose City Business License # ,(/
I certify thief in the performance of the work for which this permit is issued hall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER A W. Chappell
ADDRESS 7656 Rainbow Dr.
USE OF BUILDING Residence
FORM 29030 (REV. 3/eel IOM
Signed ..----------------
7656 Rainbow Culligan
FIXTURES FIXTURES MAIN DRAIN
Wafer Heaters Floor Drains SizeMaterial'
Water Closets' Hoppers To To Septic Tank
Bath Tubs 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. 1.0 Aackflow Preventer Storm Drain Fee
Sinks Survey Water Sys. Fee 1.00
Dental Units Gas Piping Fee
Drinking Fountains Survey
Permit Fee 2.00
TOTAL 1.01TOTAL FEE 4. 00
INSPECTOR'S REPORT HOUSE GAS PIPING
P°dial No. Lines Outlets Size
Rough Tested and Approved
Finish4— By _