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67765 (2) 7647 Rainbow Building Permit Confirmed ❑ Not Required Ia,/ CITY OF SAN JOSE BUILDING DEPARTMENT APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT Date----February--15..................... 19--.67- Permit No.--�..�.... ...( .. ---------- The undersigned herob k s app'tali t th u 6i g ns for o e City of San Jose for a permit fo ins}all plu bi f' s s I' e o�everse side. Exemption from requiremen as Ca orn' r o actors License is hereby claimed by undersigned: a owner ❑ statement filed 234281 Undersigned attests that his Stara 0' Californ'�j Contractor's License ${' is in full force and effect and properly aufhorizes fA' a�plicafii�jyy�� �y i San Jose City Business License # �( jtt I certify that in the performance of thew or * ich 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 AND)01 MUTT SOFTMASTERINC ]647 RAINBOW DIRYE 1150 DELL AVE. ADDRESS CAMPBEI L CALIF 379-5050 USE OF BUILDING IR HOUSEHOLD v 9 FORM 290-30 (REV. 3/6e1 lOM Signed-- --�r '---- 7647 Rainbow Softmaster 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 To Main Sewer Kitchen Sinks Water Leaders WATER SYSTEM DisTr h Washers ailer Space Size Material Waste Disposals Swim Pool FEES Wash Trays Indirect Wastes Fixture Fee OO Washing Machines . -Drywell Main Drain Fee Water Treat. Equip. Backflow Prevent?,o Drain Fee Sinks Survey Sys. Fee /, p O Dental Units ping Fee Drinking Fountains Fee av TOTALTOTAL FEEINSPECTOR'S REPORT HOUSE GAS PIPINGO�1OIes Outlets Size Rough Tested and Approved Finish By