97233 (2) 7582 Waterford Dr
Building Permit Confirmed ❑
_ Not Required ❑
CITY OF SAN JOSE � BUILDING DEPARTMENT
APPLICATION- FOR PLUMBING and/or GASB PIPING PERMIT
Date---------------------A- ---./a- - 19. .27 Permit No......C. _ �j---------------
Theundersigned hereby makes application to the Plumbing Inspector of the City of San Jose
for a permit to install plumb' t re d r 'p '}ydQrlJia reverse side.
Exemption from require f rector's License is hereby claimed
by undersigned: - - as wner ❑ statement filed ❑
Undersigned attests that his State of Celiforn C cfor"
is in full force and effect and properly authorizes a is
San Jose City Business License # L2—
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 /'I bf/'9 'q M A T c w E
ADDRESS 7.�T Z A GI, r&k Fo rt 0 D /L Lot No.
� /1 '
USE OF BUILDING
Signed-.��5 e..-�. 7...7 .v-':Sfv l ti 1
28030 (%
7582 Waterford Dr Ace P1bg
FIXTURES FIXTURES MAIN DRAIN
Water Heaters / Floor Drains Size Material
Water Closets Hoppers To I To Septic Tank
Bath Tubs Sand Traps RAIN WATER DRAINAGE
Showers Urinals Size
Material
Lavatories Area Drains To Curb I To Main Sewer
Kitchen Sinks Water leaders WATER SYSTEM
Dish Washers Trailer Space Size Material
Waste Disposals Swim Pool FEES
Wash Trays Indirect Wastes Fixture Fee a d
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 ,po
TOTAL TOTAL FEE 3,00
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial No. Lines
Rough .Outlets Size
Finish
Tested and Approved
B
Y