85643 (2) 1135 Kentwood
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBINGand/orand/or GAS PIPING PERMIT
Date----------.... --...1,- --------------- 19..7.6 Permit No... .. .�..���----------------
The undersigned hereby m 'a PI Inspector of the City of San Jose
for a permit to install plum r the reverse lido.
Exemption from requirem t fo tame of alifornia for Contractor's License is hereby claimed
by undersigned: a owns�dd�❑ statement filed ❑
Undersigned attests that his State �: rnia CylQr tt ensu' 1"� ����
is in full force and effect and properly h es thi e
San Jose City Business License # Y 9 — 0 ; f
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 Aolato the workmen's compensation laws of California.
11
OWNER - 13" V/EA
ADDRESS ���5 15 5/YT W d o P Lot No.
USE OF BUILDING P1 r S r d
2e0.30 Aug. as Signed v(/.C�.D..U,��.f.lC..w�f.?.�lrE ----------
1135 Kentwood V V Ace
FIXTURES FIXTURES MAIN DRAIN
Water Heaters Floor Drains Size . -Material
Wafer Closets Hoppers -' To To Septic Tank
Bath Tubs Sand Traps RAIN WATER DRAINAGE
Showers • Urinals Size Material
Lavatories Area Drains To Curb i 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
Wafer Treat. Equip. Backflow Preventer Storm Drain Fee
Sinks Survey Water Sys. Fee
Dental Units Gas Piping Fee
Drinking Fountains _ Survey
Permit Fee
TOTAL TOTAL FEE
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial ,� No. Lines
Rough Outlets Size
Tested and Approved
Finish - �U By