73693 (2) 7537 Prospect Rd
Building Permit Confirmed 6:y
Not Required '❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING `
sPERMIT
Date........... 7 - 1�� Permif No.--- --- SJR-- �C-'-'----
The unde igned Is leby matos�appliicatio Ifo the P.lumsin In of the City of San JosA'.
fora Permit fo install/plurfiBin Ifixiures�and orf pipe�lisiad onfih§�reversa side. -
p / .!ex/�I /a /�d s r ♦ i
Exemption from requirement for State of Calif?niasfor Contractor's. License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests that his State of California Contractor's License # �PG•s'7 .
is in full force and effect and properly author
isas.lhlay��pli<afion.
San Jose City Business License # "�fb!/��� /�/
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?assi�vi late the workmen's compensation laws-of California.
OWNER `S°� / ��2ari•
ADDRESS
USE 7F BUILDING `C
FORM 280-30 IOM 3/§7 I Signed--- '.------------------------
/ 1
7537 Prospect Rd Bohart
FIXTURES FIXTURES MAIN DRAIN ,
Water Heaters / Floor Drains Size Material e /
Wafer Closets y Hoppers To To Septic Tank
Bath Tubs / Sand Traps RAIN WATER DRAINAGE
Showers Urinals ze
SiMaterial
Lavatories Area Drains To Curb To Main Sewer
Kitchen Sinks i Water Leaders WATER SYSTEM
Dish Washers Trailer Space Size Material
W=Units
tDiosals Swim Pool FEES
Indirect Wastes Fixture Fee
chines Drywell Main Drain Fee �C
t. Equip. Backflow Preventer Storm Drain Fee
Survey Wafer Sys. Fee ,Cr�i
untains Survey
Permit Fee
TOTAL TOTAL FEE
INSPECTOR'S REPO HOUSE GAS PIPING
Partial ® No. Lines Outlets
Rough
Tested,and Ar e
Finish �rJ. /fiY?ie. ni •il By