26611 (2) I
670 TAMRS TOWN ROAD
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE 9 BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT.
// 'f
Date-----L...---- --. .... 19:.. Permit No._.....:�.6.�,11------------
The undersigned hereb kes licafi to t P b' Inspector of the City of Sen Jose
for a permit to install p or ip i n the reverse side.
Exemption from re ' e e a or S o alif ma For Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑ es5
Undersigned attests that his S to of California Conlrec�to�r'{s�L�icense # P
is in full force and effect and pro a IVfhovrir lir
Sen Jose City Business Licen # ///
1 certify that in the performance of the ork 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 � 77 c�J6;zl
r7a -Ta
ADDRESS /6 -,t-, "�t &,6h,< Lot No.
USE OF BUILDING
Signed -----. .'..4.�-/--Q-C.�/
T F,7n ,TAMP.(; TOWN ROAD U/Jv `"' —" —A280-,,4Oln
FIXTURES N0, FEE MAIN DRAIN
Nater Heaters Size Material
Nater Closets To Fee
Bath Tubs RAIN WATER DRAINAGE
Showers Size Material
_avatories To Fee
(itchen Sinks WATER SYSTEM
)i5h Washer Size Material
Vaste Disposals I Water Fixture Fee
Vash Trays HOUSE GASP IPING
fashing Machines No. Lines Outlets
Vater Treat. Equip. Size iFee
Sinks FEES
)ental Units Fixture Fees
)rinking Fountains Main Drain Fees
'loor Drains Storm Drain Fees
coppers Water S s. Fee
iond Traps Gas Piping Fee
Jrinals Surve
4rea Drains Permit Fee
Vater Leaders TOTAL FEE,I�
frailer Space INSPECTOR'S REPORT
iwim Pool Gas Piping
ndirect Wastes Approved
)r well B
iackflow Preventer Partial
urvey Approved
B
Rough
TOTAL Approved
B
Finish
Approved
By iii