35556 (2) X14 E!YDE AVENUE ` /
Building Permit Confirmed {�'
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date......._4�3 ---.--------------------- 19.7 Permit No.-------.�.J�. J....IC/-- --------
The undersigned hereby kes ap }i f�acfor of the City of San Jose
for a permit fo install plu in pi s e reverse side.
Exemption from requir e f r tate of Calif rn,a for ntractor's License is hereby claimed
by undersigned: a ow r �� statement filed Irl
Undersigned aftosts }hal his Stefa o onia �3 `��
is in full force end affect and proper �u((jY��''x(es
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 Me i
A)T i / LL n n
ADDRESS �1 1 ?%Jr— Hoe Lot No.
USE OF BUILDING Sir 6'/(-
Signed.. . ..C.MF.:�.L4.�.. -n,PJ-'----
914 HYDE AVENUE ERAWNER P88ZS401n
FIXTURES N FEE MAIN DRAIN
Water Heaters? Jar. Size Material
Water Closets To Fee
Bath Tubs RAIN WATER DRAINAGE
Showers Size IMaterial
Lavatories To Fee
Kitchen Sinks WATER SYSTEM
D' Washer Size IMaterial
Waste Disposals Water Fixture Fee
Wash Trays HOUSE GAS PIPING
Washing Machines No. Lines X Outlets
Water Treat. Equip. Size P�N lFee
Sinks FEES
Dental Units Fixture Fees
Drinking Fountains Main Drain Fees
Floor Drains Storm Druin Fees
Hoppers Water S s. Fee
Sand Traps Gas Piping Fee
Urinals Surve
Area Drains Permit Fee
Water Leaders TOTAL FEE
Trailer Sp ace INSPECTOR'S REPORT
Swim Pool . Gas Pi in
Indirect Wastes Appr d 9.N.7
Dr well B
3ackflow Preventer P ttiol
iurve7 Approve. )7-1
fL/ ) B
Rough
IOTA Approved
B
Finish
Ap ro ' 9-26-1
B