100008 (2) 8187 Presidio
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date igne-.d he... fmi4�No.f� -� .. ....d- ----�--
The undersreby ma es epplice}ion tote Plumbing Inspector of the City of San Jose
for a permit to install plumbing fixtures and/or pi fed on re ersgr sidar
Exemption from requirement for State of Cal r�for CoA rs�tg�u1f�h�by claimed
by undersigned: as owner ❑ statement filed Cz 3 7 �G�
Undenigned attests that his State of California Contractor's License #
is in full force and effect and properly au1�jzes }his epp icafion.
San Jose City Business License # 7 -3
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 IVAVCE-Alf /L Y
ADDRESS Lot No.
USE OF BUILDING0
280-30 Signed .4zr '!- fti)'. �Rw cP
8187 Presidio Ace ... -
I/T7
FIXTURES FIXTURES MAIN DRAIN
Water Heaters Floor Drains Size Material
Water Closets Hoppers To To Septic Tank
Bath Tubs Sand Traps RAINWATER DRAINAGE
Showers Urinals Size Material
lavatories Area Drains To Curb I To Main Sewer
Kitchen Sinks Water Leaders WATER SYSTEM
Dish Washers Trailer Space Size I Material
Waste Disposals Swim PoolVPiping
FEES
Wash Trays Indirect Wastes , c0
Washing Machines Drywell Fee
Water Treat. Equip. Backflow Preventer Fee
Sinks Survey Fee
Dental Units FeeDrinking Fountains
Permit Fee Z . 00
TOTALTOTAL FEE 3, ao
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial No. Lines Outlets Size
Rough Tested and Approved
Finish By