98887 (2) 902 Fort Baker
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR�jPLUMBING
``and/or GAS PIPING PERMIT
Da+e..-------------------'/--=...�. -- 19/.-Permi+ No.-------7�?`7
The undersigned hereby makes a plication to the Pluml�ng Inspector of the City of San Jose
for a permit to %sMd on the reverse side.
Exemptionfrom raqui' Fdm f t fC�mo fo Contractor's Licens�ClL/relay claimed
by undersigned: as owner ❑ statement filedi
Undersigned attests that his S",5t Calif aiCojfFgftnzs ���ssrcense �J
is in full force and affect and prd'pfrlv_aath0 xos fl/f5{Sp1i t l DD `�
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 s as to violate the workmen's compensation laws of California.
OWNER /
ADDRESS ` Lo+ No. !
USE OF BUILDING I
280 30 ------------------ ----- --------- -------------------------
902 Fort Baker Lifetime
FIXTURES FIXTURES MAIN DRAIN
Water Heaters Floor Drains Size Material
Water Closets Hoppers ToTo Septic Tank
Bath Tubs Sand Traps RAIN WATER DRAINAGE
Showers Urinals SizeMaterial
Lavatories Area Drains To Curb To Main Sewer
Kitchen Sinks Water Leaders WATER SYSTEM
Dish Washers Trailer Space Size I Material
Waste Disposals ISwim Pool FEES
Wash Trays Indirect Wastes Fixture Fee
Washing Machines Drywell Main Drain Fee
Wafer Treat. Equip. Z Backflow Preventer Storm Drain Fee
Sinks ISurvey Wafer Sys. Fee
Dental Units IGas Piping Fee
Drinking Fountains Survey
Permit Fee
TOTAL TOTAL FEE
INSPECTOR'S REPORT HOUSE GAS PIPING
No. Lines Outlets Si
Rough Tested and A—pp�rovved—G.��
Finish 2 By L ��i 2A n,r ,