80232 (2) 1040 Colony Hills
Building Permit Confirmed 9—
Not Required 1-1
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date----------------------- - T ( O Z
-_............ 194.1 Permit No.----.:.....51 - - ------------------
The
- -- ...
_ The undersigned hereby ".f
h��nn bine ecfor of the City of San Jose
for a permit to install plu inpips sdsd d th reverse side.
'Exemption from raquir or is F r o attar's License is hereby claimed 9
by undersigned: statement filed ❑�D
Undersigned attests that his State of aHfornia Contracfor's License
is in full force and effect and roperly auth rices this ap lit ti Q lj
San Jose City Business Lic ns I� I� �
I certify the in the perfo f i e wr: or I1, is arm is issued I shall not employ
any person in amanner'so a to late the w kmen's compel ati n
ny laws of California.
OWNER
ADDRESS c 0
USE OF BUILDING s6U
200-30 10-68 Signed----- -------
-------- -- --------- ------
Al AO/NS S
Anthony1040 Colony Hills
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 31�zOl Material
Waste Disposals Swim Pool FEES
Wash Trays Indirect Wastes Fixture Fee
Washing.Machines Drywell Main Drain Fee
Water Treat. Equip. / Backflow Preventer /- Storm Drain Fee
Sinks Survey Water Sys. Fee
Dental Units Gas Piping Fee
Drinking Fountains Survey
Permit Fee
TOTAL TOTAL FEE
INSPECTOR'S REPORT HOUSE GAS PIPIO{G
Partial / 9 �l No. Lines O Size
Rough Tested and Approved
Finish By �