94226 7573 Waterford
Building Permit Confirmed ❑
Not Required
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT .
a-
Date---- ------- C�----'-------------. I /... Permit No..............1 `�
.-- .0--------
The undersigned hereby �applicafionhPlumbing Inspector of iha Cily of San Josa
for a permit to install Plu rliereverse side.
Exemption from requir r ntac}or'sLicense is hereby claimed
by undersigned: statement ❑
Undersigned attests that his State of Califia
is in full force and effect and properly eutvA
horixosornchis C p _4iop
San Jose City Business License # ,/ '� y /
I certify that in the performance of the work For which this permit is issued I shall not employ
any person in any ma r so as to�ioleta }h@ workmen's compensation laws of California.
OWNER r L 2
ADDRESS 7-57.3 W �
USE F UILDING n � r
ALWIN PLE A TNIG CO.
257€oRRMPieo�3oL�q-rft!7 ROAD Signed-C --------------- - ------- ------------------
REDWOOD CITY, (;A �. 365-0714
rAlwin P1bg
7573 Water or
FIXTURES FIXTURES MAIN DRAIN
Wafer Heaters !Area
r Drains Size Material
Water Closets pers To To Septic Tank
Bath Tubs d Traps RAIN WATER DRAINAGE
Showers als Size Material
Lavatories Drains To Curb To Main Sewer
Kitchen Sinks Water Leaders WATER SYSTEM
Dish Washers OD 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
Drinking Fountains Survey
_ Permit Fee v.
TOTAL TOTAL FEE --7
INSPECTOR'S REPORT HOUSE GAS PIPING
Pallial No. Lines
Rough Outlets Size
FiniTested and Approved
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