33597 (2)942 FORT BAKER
CITY OF SAN JOSE
Building Permit Confirmed ❑
9 Not Required ❑
BUILDING DEPARTMENT
APPLICATION
/FOR PLUMBING and/or GAS PIPING PERMIT
Date/--'�r/"..:..-�L�....... .............. I wPermi# No. ..... 33-SY7----------------
The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose
for a permit to install plumbing�ff'J'''���tt rre�e -� jan.d/o,.r.( P I' e o e averse side.
E.ampfion from requirerrLniQov�Sfat�of593 nu r tee
License is hereby claimed
by undersigned: as owner ❑ statement filed
Undersigned attests that his State of c a�ifornia Conj.�acfp Lic ns�
is in full force and effect and properly i n: thi�q¢¢Ijtt
.C>�//
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.
OWNER
ADDRESr.
USE OF
942 FnRT BAKER
Size
WA
4
(itchen Sinks
WATER SYSTEM
)6sh Washer
Size Material
Vaste Disposals
Water Fixture Fee
lash Trays
HOUSE GAS PIPING
lashing Machines
No. Lines Outlets
later Treat. Equip.
Size IFee
Sinks
FEES
)ental Units
Fixture Fees
)rinkinq Fountains
Main Drain Fees
:Ioor Drains
I Storm Drain Fees
coppers
Water Sys. Fee
fond Traps
Gas Piping Fee
Jrinals
Survey
Area Drains
Permit Fee _
Yater Leaders
TOTAL FEE C -2r
frailer Space
INSPECTOR'S RE RT
iwim Pool
Gas Piping
ndirect Wastes
Approved
)r well
B
iackilow Preventer
Partial
urvey
I Approved
e..
Finish