67486 (2) 758 New ba§tLe
9 Building Permit Confirmed ❑
Not Required L--�
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date..._..//'3.qL... ..Z'- 19 _... Permit No.....-------_(0--- ..L../..O.. --------
The undersigned hereby ma s I' o PI ri bi Io/I�.or of }ha City of San Jose
fora permit fo install plumbi as to everse side.
Exemption from requirement for afe of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑ - ��
Undersigned attests that his State Of Califoryy�',�Contractors License #'
is in full force and effect and properly euthorize�16plicafio
San Jose City Business License #
I certify that in the performance of the work for which this permit is issued I shall not employ
an erson in anma ar so a o violet
OWNER
the workmen's compensation laws of California.
y y �
ADDRESS 7's
Ip1J
USE OF BUILDING
—
]PIERCE PLUIs1BINCi
FORM 2e0-30 (REV. 3661 IOM
Signed-------- ---am- MERIDIAN--AVE..# SY..._..----...
8A(4 JOSE. CALIFORNIA
7538 New Castle PYrce
FIXTURES FIXTURES MAIN DRAIN
Water Heaters Floor Drains Size Material
Water 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
Washing Machines Drywell Main Drain Fee
Water 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
Rough No. L'nes Outlets Size
g - Tested and Approved
Finish 2 . /. 7 B
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