88409 (2) 914 Blazingwood Ave
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Datel ------------- ----------- 192D... PermitNo......0.. .7.. ......................
-The undersigned h oby a es li o o.lL�-71ufID�6i�ry/ cfor o4 the Cily of San Jose
for a permit to insta plu u i' I1Pod/ reverse side.
Exemption from t f if, n♦�'a for Factor's license is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned a}fOne
hat his State of California Contractor's License # ? 7 o $�
is in full force and an oporly aufh$�'�es/�}his/ pi t'
San Jose City B is # lJ�srr/�/.�V1,7/-�i Y
I certify the inrf ante of�i ie_ or r w mh mi is issued I shall not employ
any person in any m as to violate the workmen's compensation laws of California.'
OWNER 04,_O� a 'o�')
ADDRESS _�/� ALN -�n,Tn n�/�E Lot No.
USE OF BUILDING—&—
soao Aug. 69 . � ' Signed CW2P..�iyy..J�" -./�-.'< L1 ------
// o
914 Blazingwood Ave Ace Plumbing
FIXTURES FIXTURES MAIN DRAIN
Water Heaters Floor Drains Size Material
Water Closets Hoppers To j 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 - SizeI Material
Waste Disposals Swim Pool FEES
Wash Trays Indirect Wastes Fixture Fee w�
Washing'Machines Drywell Main Drain Fee
Water Treat. Equip. Backflow Preventer Storm Drain Fee
Sinks Survey Wafer Sys. Fee
Dental Units Gas Piping Fee
Drinking Fountains Survey
Permit Fee .�
TOTAL TOTAL FEE
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial No. Lines Outlets Size
Rough 52 Tested and Approved
Finish By