74209 (2) 7633 Prospect Rd
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date....._.V//. ---- 19✓0 Permit No.......... �.��Z(/.. .-----------
Permit �`
The un ersigned hereby kes applicatio to iLe bin I or of the City of San Jose
for a permit to install pl in f• a jIa is n verse side.
Exemption from req ' ate ali o ni f onfractor's License is hereby claimed
by undersigned: owner ❑ statement filed ❑
Undersigned attests that his State of al forms Contract..=s License #/��O
is in full force and effect and properly eft r'/✓is ./i
San Jose City Business License #
I certify that in the performance of the work for which this permit`is is ed 1 shall not employ
any person in any manner so a to violate f a workmen's compensation laws of California.
OWNER �•
ADDRESS 7Gs D
USE OF BUILDING
FORM 200-30 IOM 3/67 Signed-- --- ----- -----------------------------------------------`-
7633 Prospect Rd" xRzsa Bohart
FIXTURES FIXTURES MAIN DRAIN
Water Heaters / Floor Drains Size Material
Water Closets Hoppers To To Septic Tank
Bath Tubs i Sand Traps RAII9 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 Machines Drywell Main Drain Fee G9
Water Treat. Equip. Backflow Preventer Storm Drain Fee
Sinks Survey Water Sys. Fee 110-lJ
Dental Units Gas Piping Fee
Drinking Fountains Survey
Permit Fee
TOTAL TOTAL FEE / ;,rd
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial D'G No. Lines Outlets Size
Rough Tested and Approved
Finish o
' s . By if-�i�✓J