85035 (2) _ _ _
LL'59 Kentwood' Ave.
Building Permit Confirmed ❑
Not Required' ❑ .
CITY .OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date..----------------. ------- 1920 Permit No..--------Pl...�.1. -L3- -`----
Tho undersigned y m s ppli a}ion to�fhe Plumbing Inspector of the City of Son Jose
{ora permit 4o in all n o p' a on the reverse side.
Exemption from requi eni o State f a iforn is or Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed Z.37 SO�
Undersigned attests that his State o C ornia onfractor's L'�nse #'
is in full force and effect and properl %� _
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 « -Fc-r!I h(•
ADDRESS /�`S� �'1E-'NTc000b 4V Lot No.
USE OF BUILDING n
28030 Aug. 69 Signed . �CZ...Jah: CQ r...,
Y ....
LL59 Kentwood. Ave.. Ace PLumbing Service
FIXTURES FIXTURES MAIN DRAIN
Wafer 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 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
WNo Washing Machines Drywell in FeeWater Treat. Equip. Backflow Preventerin FeeSinks Survey s. FeeDental Unitsg FeeDrinking Fountains ' e Z.c oTOTALOTAL FEE 7 o oINSPECTOR'S REPORTHOUSE GAS PIPING 4Partial Ouflefs Size
Rough ( J A� Tested and Approved
non 7 r� —/ -t-NreJLv-cam B .
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