92673 (2) 1340 Primrose
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT:
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date.........----------Cr--. -_---�------^ 19.7 .. Permit No.......`._vOl--------------------
The undersigned hereby 7kes application to the Plumbing'Inspector of the City of San Jose
for a permit to install pluming'flvtur rrrrrorloi'e�lis�d'on}h�ra�erse side. -
Exemption from regwrement�fo $ fyCalifornie�fosrCon#rlac#o'r's License is hereby claimed
by undersigned: aVowner ❑ statement filed
Undersigned attests that 'his State of California Con}rector's License # 7 yG�
is in full force and effect end properly authorizes }his a plieetion.
San Jose City Business License / 0�///P//e/ (/T,�
I certify that in the performance of the work for which }his permi�shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNERLL�AC C. F! C E J7,
ADDRESSLotSNo.
USE OF BUILDING y2��
28030 Signed..G�.G.c..l�-- ��_`"... °"t:c•-c=s.t... ,> ..
1340 Primrose Ace Plumbing
i
MKitchenSinks
URES FIXTURES MAIN DRAIN
rs / Floor Drains Size Material
ts Hoppers To To Septic Tank
Sand Traps RAIN WATER DRAINAGE
Urinals Size Material
Area Drains To Curb To Main Sewer
s Water Leaders WATER SYSTEM
Dish Washers Trailer Space Size Material
Waste Disposals Swim PoolV
FEES
Wash Trays Indirect Wastes /,ov
Washing Machines Drywell ee
Wafer Treat. Equip. Backflow PrevenferFee
Sinks Survey eDental Units ee
Drinking Fountains Survey
Permit Fee 2, ov
TOTAL TOTAL FEE 1 13 .u v
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial No. Lines Outlets Size
Rough Tested and Approved
Finish r) - Lb ` )/ Jd f�i��_ By