89897 (2) �..
1,7$yr:>Orion Lane
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GASPIPINGPERMIT
Date------1 - _-- -- U--------. 19.._.... Permit No....._---- 7
3
The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose
for a permit to install plumbing fixtures and/or pipes listed on the reverse side.
Exemption from requirement for State of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests that his State of California Contractor's License
is in full force and effect and properly authorizes this application.
San Jose City Business License # �'/ /O �/ -,Z
1 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 .4� /e/• /1
ADDRESS 7b S / d ea 2 L i1/ Lot No.
USE OF BUILDING ,Z, z)'
280 30 Signed . � -1------------._..
7851 Orion Lane AAA- Plum inq Company
FIXTURES FIXTURES ( MAIN DRAIN
Wafer 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 MachinesDrywell Main Drain Fee Z �-
Water Treat. Equip. Backflow Preventer Storm Drain Fee
Sinks Surve Water Sys. Fee
Dental Units - GH Gas Piping Fee
Drinking Fountains Survey
Permit Fee
TOTAL TOTAL FEE
INSPECTOR'S REPORT
Partial HOUSE GAS PIPING
Rough No. Lines Outlets Size
Tested and Approved
Finish By