85373 (2) 7624 Rainbow Dr
Building Permit Confirmed ❑
Not Required LT
CITY OF.SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
T
Date---- --��.:.........--------------. 19�L' Permit No.---------��-`- --72........--"----
Tha undersigned�"epp
kat' n to the Plumbing pector of the Ci}y of Sen Jose
(orapermit }o insta plu ip s e reverse side.
Esemp}ion from o A a r ntrac}or's License is.hereby claimed
by undersigned: asowner ❑ statement filed ❑ Qa
Undersigned attests that his State o�California Contractor's License # L�
is in full fsyco and effect and properly utr�is a a
San Jose City Business Licennse # a
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�L/�C-�1-/Y, y
ADDRESS _7 /�C _y� �"UV/�A�✓'�� ��' . Lot No.
USE OF BUILDING_4) C
280-30 Aug. 69 Signed-_Lf[-.�'P�._ 1-L .r..-..
7624 Rainbow Dr Ace Plumbing Se ice
FIXTURES FIXTURES MAIN DRAIN
Wafer Heaters Floor Drains Size Material
Wafer Closets Hoppers To I To Septic Tank
Bath Tubs Sand Traps RAIN 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 j%TOTAL
Fixture Fee _
Washing MachinesMain Drain Fee
Wafer Treat. Equip. Storm Drain Fee
Sinks Wafer Sys. Fee
Dental Units as Piping Fee
Drinking Fountainsurvey
ermit Fee
TOTAL FEE
INSPECTOR'S REPORT,,— HOUSE GAS PIPING
Partial i- — No. Lines Outlets Size
Rough Tested and Approved
Finish By