97746 (4)' 7458 Bollinger Rd. GI //'
Buildingm
,Permit Confired 41
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS 7PIPINGG PERMIT
Date._—J-���.--7.7i 19-------. Permit No.._C7....1...7..-7---t/------------------ '
The undersigned hereby k s p 'c a PI g Inspector of the City of San Jose
fora permit }o install plumb ng i u s or i a li d on the reverse side.
Exemption from requirem a f r is for Contractor's License is hereby claimed
by undersigned: as o er statement filed ❑
Undersigned attests that his State of 'fornia Contr ctar's License #
is in full force and effect and properly autho ex is ap a io
San Jose City Business License
I certify that in the performance of the work r which this permit is is ed I shall not employ
any person in any manner so as to' io`latte the workmen's compensation laws of California.
OWNER �h,,/l//�/�iC /� /����J7/,✓O�
ADDRESS �`f BUGG/�G��'–' Lot No.
USE OF BUILDING ....
—
-- ---+ tC.,/�-- ll ay--------"---it
zeo ao \ I Signed
7458 Bollinger Rd. D. Martin
FIXTURES FIXTURES : : MAIN DRAIN
Wafer 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 0:
Washing MachinesDrywell Main Drain Fee
Wafer Treat. Equip. Backflow Preventer Storm Drain Fee
Sinks Survey. Wafer Sys. Fee '
Dental Units Gas Piping Fee
Drinking Fountains I Survey
Permit Fee y,
J— Z TOTAL TOTAL FEE 7 &V--
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial No. L Outlets Size
Rough Tested and A e
Finish. By
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i i