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73851Building Permit Confirmed ❑ Not Required H�— CITY OF SAN JOSE BUILDING DEPARTMENT APPLICATION FOR PLUMBING and/or GAS PIPI/N'G7PERMIT Date .... .... Feb...... 21 ....................... 19.68. Permit No. ---------- G ------ .L.._r1..iJUJI The undersigned hereby ak Ot�ow hi➢g II of the City of San Jose for a permit to install p bb ste a rse side. Exemption from req ' t or's License is hereby claimed by undersigned: statement filed ❑ Undersigned attests that his State of lifo ie Contracfor' License # 216217 is in full force and effect and properly #' fh this applic�/� San Jose City Business License I certify that inthe performance of the work for which f is permit is issue shell not employ any person in any manner so as fo violate the workmen's compensation laws of California. OWNER Patrick Morton ADDRESS 7678 Rainbow Dr. USE OF BUILDING Residence FORM ZaO-30 (REV. 3/661 IOM Signed ........ ..... .. - 7678 Rainbow vt C 11Wn FIXTURES FIXTURES MAIN DRAIN Wafer Heaters - Floor Drains Size Material Wafer Closets 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 Washing Machines- Drywell Main Drain Fee Water Treat. Equip. . 00 Backflow Preventer Storm Drain Fee Sinks Survey Water Sys. Fee 1.00 Dental Units Gas Piping Fee Drinking Fountains Survey Permit Fee 2.00 TOTALTOTAL FEE 4.00 INSPECTOR'S REPORT HOUSE GAS PIPING Parfial- Rough No. Lines Outlets Size IlTested and Approved