85354 (2) 1601 Sar-Sunnyvale
IIBuilding Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATII�O4--J-0
-N FOR PLUMBING and/or GAS PIPING PERMIT
Date....----------�--4- /0--------------- 19.70.. Permit No............
[1. 3 .........
The undersigned hereby k s epplic ;on to A lumb' 1pspector of the City of San Jose
fora permit to install plu in fi our r list o 4�0 side.
Exemption from requ' ale ah o r r o 'cense is hereby claimed
by undersigned: es caner ❑ statement filed ❑ r
Undersigned attests that his State of Califer ' Contractor's License # X 9 S Z�. a
is in full force and effect and properly authorizes i lication. �/
San Jose City Business License # c''4'°/
1 certify that in the performance of the work for which this permit is issued Ishall no employ
any person in any manner so as to violate th workmen's compensation laws of California.
OWNER
ADDRESS /G° r
USE OF BUILDING 3 -
FORM 280-30 10M 1/68 Signed.....��.-._..C�r3-arm-... kc>�.-----------
/,?70
p
1601 SSr_-5unrxv-va1fi RA
FIXTURES FIXTURES MAIN DRAIN
Water Heaters Floor Drains Size - Material
Water Closets Hoppers To To Septic Tank
Both Tubs Sand Traps RAIN WATER DRAINAGE
'.Showers Urinals SizeMaterial
Lavatories Area Drains To Curb To Main Sewer
Kitchen Sinks Water Leaders WATER SYSTEM
Dish Washers Trailer SpaceSize Material
Waste Disposals - Swim Pool FEES
Wash Trays Indirect Wastes Fixture Fee c G
Washing Machines Drywell Main Drain Fee
Water Treat. Equip. Backflow Preventer Storm Drain Fee
Sinks Survey Water Sys. Fee
Dental Units Gas Piping Fee
Drinking Fountains Survey
Permit Fee Z. 00
TOTAL TOTAL FEE
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial n No. Lines Outlets Size
RoughTested and Approved
Finish - - t By