85536 (2) B051 Presidio Drive
Building Permit Confirmed U,
Not Required - ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or..GAS PIPING PERMIT
Date --------------..-----------------------.......-.. 19........ Permit No....!..�—.�.�
The undersigned hereb�l��a liGfii ` t yylJs irk�i�lnspector of the City of San Jose
for a permit to install plumbing s $nd/or 01 eS lI' on the reverse side.
Exemption from requirement for State of California for Contractor's License is hereby claimed
by undersigned: as owner I qq�� state mo t filed ❑
Undersigned attests that his State of aBifp C�gpr;(sfLi�me 3 ?'C3
is in full force and effect and properly au �icas�this app�ca/on.
San Jose City Business License #-( 3 E/ 2 _
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 Ri r Li AtW
ADDRESS ro J-/ le c I C/ o Lot. No.
USE OF BUILDING Pr v . �R/e S'go-
280 30
o-28040 Aug. 69
Signed----Cc... .-.as .- ...........
y1 r Ard 6j'•° Ls Secard Pools
Fr
80 1 esi io ive
r
FIXTURES FIXTURES MAIN DRAIN
Water Heaters / Floor Drains Size Material
i Water Closets Hoppers To Ta Septic Tank
Bath Tubs Sand Traps I 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 Fmaterial
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 H99SEG S P ING
Partial
Rough A n No. Line Oufle Size
Tested rove
Finish —!U .LTJ ay