85257 (2) 858 East Egtates Dr
Building Permit Confirmed Ftl
Not Required L]
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING
PIPING PERMIT
Date---- -- - --------2D---- 14, ... Permit No----- 5 z.S�7------------
The undersigned hereb makes application to the Plu ing Inspector of the City of San Jose
fora permit to install I m 6 ur d /�/i s f on the reverse side.
Exemption from regp or t (!al or Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests that his pStateroperly
of Calstirnie Cif i nre #
is in full force and effect and properly aufh x s his
San Jose City Business License
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.
OWNERnT.4Z5 !yam 'Pte s
ADDRES$dFS-1- Lot No. 59
USE OF BUILDING - n
28030 Aug/69 Signed....... _ .. --- -If'��`---_---------:
858 East Estates Dr J nes
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 Size Material
Waste,Disposals Swim Pool FEES
Wash Trays Indirect Wastes Fixture Fee ��—
Washing Machines Drywell Main Drain Fee 7
Wafer Treat. Equip. Backflow Preven}er 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 .a— No. Lines Ouflefs Size
Rough 10 Y ( Tested and Approved
Finish By