NO PERMIT NUMBER (2) 7409 Fallen Leaf Ln
Building Permit Confirmed ❑
Not Required GY
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date----------------------------------------------- 19........ Permit No.-------------------------------------------
Tha undersigned hereb makes ep i on 1 PI g Inspector of the City of Sen Jose
for a permit to install U d r �on the roverse side.
Exemption from re r or to ali ornia for Contractor's License is hereby claimed
by undersigned: as owner st m t
Undersigned attests that his State of aliforact '
is in full force and effect and properly authorizes i- application.
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 o as to/violate the workmen's compensation laws of California.
OWNER `l//- /`so' KiVt«
ADDRESS 77,990 FY,146 4l
USE OF BUILDING PSS P Dt NC�p
FORM 280-30 10M 3/67 Signed ..�—..�...'..fl:............. .....................................
7409 Fallen Leaf Ln Kahoves
FIXTURES FIXTURES MAIN DRAIN
Water Heaters Floor Drains SizeMaterial
Closets Hoppers To To Septic Tank
Bath TubsSand Traps RAIN WATER DRAINAGE
Showers Urinals Size Material
,Water
Lavatories AreaDrains To Curb To Main Sewer
Kitchen Sinks Water Leaders WATER SYSTEM
Dish Washers— -Tr—a—iler Space Size Material
Waste Disposals Swim Pool FEES
Wash Trays Indirect.Wastes Fixture Fee —
Washing Machines Drywell Main Drain Fee
_Wafer Treat. Equip. Backflow Prevenfer Storm Drain Fee
Sinks Survey Water Sys. Fee
Dental Units Gas Piping Fee
Drinking Fountains Survey
Permit Fee
TOTAL TOTAL FEE pQ
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial No. Lines Outlets Size
Rough Tested and Approved
Finish (/ •� -7. 6f'�. 1�ir_ By
1