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81751 (2) 1655 Saratoga-SunnyvaLe Rd. Building Permit Confirmed ❑ Not Required ❑ CITY OF SAN JOSE BUILDING DEPARTMENT APPLICATION FOR PLUMBING q and/or GAS PIPING PERMIT Date......-6---- ----j -------..... M L.. Permit No.----------e�-/7 ........---......---------- Tha undersined hereb makes application to the Plumbing Inspector of the City of San Jose fora permit tog install mb' {'1 s o //�sy''�'�`J/y,�'"versa side. 6empfion from re � orn iWeEfor's License is hereby claimed by undersigned: I as owner ❑ statement filed ❑ Undersigned attests that his State of/Calif rni Contractor's License # 2 tF9 9' is in fulan force and effectBusiness and properly au0 Ks i W— A ,�� Sen Jose City Business Licens¢ # h/�y� I certify that in the performance of the wor for which this permif is issuedI 'shall not employ any parson in any mannfer so as to violate the workmen's compensation laws of California. OWNER Pe / C 4 f/5/ -- ADDRESS ll 5- S/d/l r /o 9/J '— a A A Y(1.4 /c Rc,�, USE OF BUILDING��S ��R��f L OT NjoA __ FORM 280-30 IOM 1/6e Signed ......... - - -- - -....... ---------------' 1655 Saratoga-Sunnyvale Rd. L.L. Jona JR. _ FIXTURES FIXTURES MAIN DRAIN Water Heaters Floor Drains Size a Material Water Closets Hoppers / To C K r f 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 WashersTrailer Space Size r , Material Waste Disposals Swim Pool FEES Wash Trays Indirect Wastes Fixture Fee 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 2- TOTAL TOTAL v TOTAL FEE INSPECTOR'S REPORT HOUSE GAS PIPING Partial No. Lines Outlets Size Rough _ Tested and Approved Finish By