91433 (2) 845 Cottonwood y
Building Permit Confirmed (�
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT.
Date----.(---^---- ------------ 19/;.'/-. Permit No.------- ------------------
The undersigned hereby makes pli at'on t the bin pecior of 4he City of San Jose
for a permit fo install plum >Fg d d t e reverse side.
Exemption from require r ate o ' r ntractor's License is hereby claimed
by undersigned: a owner ❑ statement filed ❑
Undersigned attests that his }ateof Ca life ni Contractor's License # -7pj'�SJ!'e
is in full force and effect and properly authorizes } a io
San Jose City Business License # �/ �-
I certify that in the performance of the work for which this permit is issued•••{{{shall not employ
any person in any manner so as to violate the workmen's compensation laws of California. r'
OWNER �i�/G•L'y�� ��i5:0
QyS /d/!/ 41,000 Lot No.
ADDRESS Oe %�j
USE OF BUILDING S
260-30 I Signed_ / --
845 Cottonwood Zimmerman
FIXTURES FIXTURES MAIN DRAIN
Water Heaters floor Drains Size Material"
Wafer Closet_z
Hoppers To ,F,f'ts � To Septic Tank
Bath Tubs / Sand Traps RAIN WATER DRAINAGE
Showers Urinals Size Material,'/r
Lavatories Area Drains Si 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 3
Washing Machines Drywell Main Drain Fee �; —.
Water Treat. Equip. Backflow Preventer Storm Drain Fee 't .�
Sinks Survey Water Sys. Fee
Dental Units Gas Piping. Fee'
Drinking Fountains Survey
Permit Fee
TOTAL TOTAL FEE '`
t.
INSPECTOR'S REPORT HOUSE GAS PI ING
Partial _8-- LNo. nes Outle Size
Rough and ApprovedFinish