82683 (2) 1151 Kentwood Ave.
Building Perm l;Conf-rrmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Ili. ... Permit No.....9��2p..Qp
JJ..................
The uadersi, a hereby kes a ice io to {{{{{{P,,,l,,,u g Inspector of the City of San Jose
for a permit to,ins}all pu in x re r p �on the reverse side.
Exemption from requir n a f al i r r Contractor's License is hereby claimed
by undersigned: a owner ❑ statement filed ❑
Undersigned attests that his State of C o Contract.r', Licffnse # t4>,3j;
is in full force City
affect and prop#y auiho is eq �,/ .
San Jose Cit Business License 1a / �(
I certify +hat 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
ADDRESS
USE OF BUILDING
Signed.. ..�-.l L'--- ------------
280.30 10-0e n"
1151 Kentwood Ave. ill ' s PLbg. Service
1
FIXTURES FIXTURES MAIN DRAIN
Wafer Heaters Floor Drains Size .y�' Material (2.2
Wafer Closets Hoppers To 7' To Septic Tank
Bath Tubs / Sand Traps RAIN WATER DRAINAGE
Showers Urinals Size Material
Lavatories Area Drains To Curb To Main Sewer
Kitchen Sinks Wafer 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
Partial
INSPECTOR'S REPORT HOUSE GAS PIPING ,.
- No. Lin .Size'
Rough Tested and Approved
Finish p. _G 4 By