94621 (2) 1119 Milky Way 9
Building Permit Confirmed ❑
Not Required L7�
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT "
Date-------.............--=7-- -3-�-- --- 197e.. Permit No.-- --------(--6-Z/...............
The undersigned h e a gQ +o spec+or of the City,of San Jose
fora permit to install um Nffu s n pi d the reverse side.
Exemption from requirem t for S+ate of California for Contractor's License is hereby claimed ..
by undersigned: as owner fJte m it
gyp✓
Undersigned attests that his State o( C r o n t o s nse # 7o�
is in full force and effect and properly authorizes this ap(/Rlica}ion.
Z//San Jose City Business License # � 0l e/
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 /Ve/Z/660 T
ADDRESS ��� `/ n y �'N Lot No.
USE OF 1UILDING
Signed
IBOdO /OOO✓ ,
1119 Milky Way Ace Plumbing Service
FIXTURES FIXTURES MAIN DRAIN
Wafer Heaters - r Floor Drains Size Material
Water Closets Hoppers To To Septic Tank
Bath TubiSand 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 SpaceSize Material
Waste Disposals Swim Pool • FEES
Wash Trays .Indirect Wastes Fixture Fee � pV
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 1, ea
TOTAL TOTAL FEE 3, a0
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial o- lines Outlets Size
Rough � N
Tested and Approved
finish / ^ 2f- 1/ /`/Ad( j/l By