96545 (2) 7528 Dela Farge
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR
c�PLUMBING and/or GAS PIPING PERMIT
Date--`---------------:3-------7-------. 1972.. Permit No-----�--&-Y,/V:S..
---------------
The undersigned h y ma plic tion to he Plu g Inspec}or of the City of San Jose
for a permit to in sf p i r r a on the reverse side.
Exemption From n f e if is r Confreclor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests that his Stale of Cali is tractor ice
is in lull Force and effect and properly euth x applic or
San Jose City Business License # 2— _ �6 Lr�O
I certify that in the performance of the work for which this permit is issued I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California. -
OWNER 1?1661,VS C
ADDRESS
7 rZ � n��A F'g26 E Lot No.
USE OF BUILDING
28030 � `
Signed L/ e. L�f '4. L-- .....------- ---------
7528 Dela Farge Ace Plumbing
FIXTURES FIXTURES MAIN DRAIN
Water Heaters Floor Drains Size Material
Water Closets Hoppers I 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 Fmaterial
Waste Disposals Swim Pool FEES
Wash Trays Indirect Wastes Fixture Fee ' /, p o
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 Z, p
TOTAL TOTAL FEE ,3 vn
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial No. Lines Outlets Size
Rough Tested and Approved
Finish By