14915 (4) 1464 James Town drive
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS
/[PIPING PERMIT
Date - - 19. _. Permit No. .L.._T.../.I ..............
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The undersign herab makes app'cat' n to fhe,,Pluml�i Inspector of the City of San Jose
for a permit to install p m or sAis the reverse side.
Es.mption from ra r o li i f ontrector's Licenso is hereby claimed
by undersigned: as owner ❑ statement filed -053
Undersigned 'attests that his Sfafpp of California ContJJactor's License #
22?1-
is in full force and effect and properl9�au =zes s ¢' a
San Jose City Business License 7(I�GJJ�tTT � w
I certify that in fhe performance of the work for which this pofmit is issued I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER kANC
ADDRESS vkA Lot No. b
USE OF BUILDING T Sw.k AA P00 v..,-L
280-30(9-73)t Signed .....eTSMM40W.rl--
I
1464 Jamey tnum pnnaet
FIXTURES NO. FEEI MAIN DRAIN
Nater Heaters ISize Material
Nater Closets I To ILe.
3ath Tubs RAIN WATER DRAINAGE
Showers Size Material
_avatories To Fee
(itchen Sinks WATER SYSTEM-
)'sh Washer Size Material
Vaste Disposals Water Fixture Fee
Vash Trays HOUSE GAS PIPING
Vashinq Machines No. Lines Outlets
Vater Treat. Equip. / Size Fee
Sinks FEES
)ental Units Fixture Fees
)rinking Fountains Main Drain Fees
-loor Drains Storm Drain Fees
Hoppers Water S s. Fee
Sand Traps Gas Piping Fee
Urinals Survey
Area Drains Permit Fee
Nater Leaders TOTAL FEE
Trailer Space INSPECTOR'S REPORT
Swim Pool / Gas Piping
ndirect Wastes Approved
)r well B
3ackflow Preventer Partial
arvey APpro ed �2�' •�)
B
Rough
TOTAL Approved
B
Finish
A proved7,-/46y--
B