92978 (2) 7385 Rainbow Drive
Building Permit Confirmed ❑
Not Required 13
CITY OF SAN JOSE BUILDING DEPARTMENT
APP (CATION FOR PLUMBING and/or GAS PIPING PERMIT
5 97 5
Dafe ... - - ...°..... ........------ -- 1911- Permif No.------------/..-T'.----- .........
The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose
for a permit to install plumbing fixtures and/or pipes listed on the reverse side.
Exemption from requirement for State of California for Contractor's License is hereby claimed
by undersigned: as owner 2-- statement filed ❑
Undersigned attests that his State of California Contractor's License #
is in full force and effect and properly authorizes this application.
San Jose City Business License # ,
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- MyI Jt -� �'IQ_c,&-
ADDRESS -WS- 7Z�AA'�""' KT' ' YLof No.
USE OF BUILDING_ ���
Signed
28030
7385 Rainbow Drive Ilich
FIXTURES FIXTURES MAIN DRAIN
Water Heaters Floor Drains Size Material
Water Closets Hoppers To - To Septic Tank
Bath Tubs Sand Traps RAIN WATER DRAINAGE
Showers Urinals Size � Material
Lavatories Area Drains To Curb I To Main Sewer j/
Kitchen Sinks Water Leaders WATER SYSTEM
Dish Washers Trailer Space Size I Material
Waste Disposals Swim Pool - FEES
Wash Trays Indirect Wastes Fixture Fee G/, 00
Washing Machines Drywell Main Drain Fee
Wafer Treat. Equip.1 Backflow Preventer Storm Drain Fee 2• 06
Sinks Survey Water Sys. Fee
Dental Units Gas Piping .Fee
Drinking Fountains S Survey
Permit Fee Z, 00
TOTAL TOTAL FEE v
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial No. Lines Outlets Size
Rough
Fmuh •)l7� � f) Tested and Approved
BY