1762 5926 Sutton Park Place
VI Building Permit Confirmed ❑
_ 11 Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or
and/or. GAS PIPING PERMIT
Date....------------------- 1'.
.. �.Z. -- /'J .
19Permit No.----...------- _ .........
The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose
for a permit to instal rK o ifIen-lSt9 fhe reverse side.
Exemption from ra it o o if me or oniracfor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑ O Z,zO
Undersigned attests that his State of Cp�A"slifornia Contractor's License
is in full force and effect and properly au�yl this a�a;ljyrf//'�j �SS
Sen Jose City Business License # iyy !/��� �af�
I certify that in the performance of the work for which this permit is-Issued I shall not employ
any person in any man or so e to violate the workman's compensation laws of California.
OWNER � �"�' B,�tS��
ADDRESS O/✓ Lot No.
USE OF BUILDING -S� c/ Li= �5 —
5926 Sutton Park Place AtIffi�
28030
WDM/ ra oo�t
'FIXTURES FIXTURES MAIN DRAIN
Water Heaters Floor Drains Size Material
Water 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
Wafer Treat. Equip. Backflow Preventer Storm Drain Fee
Sinks Survey Water Sys. Fee
Dental Units Gas Piping Fee 3,6
Drinking Fountains Survey
Permit Fee
TOTAL TOTAL FEE
I SPECTOR' EP RT HOUSE GAS PIPING
Partial 2 - No. Lines Outlets/ Size
Rough Tested and Approved
Finish 7 By - eZ
p