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74998 (2) 1127 Kentwood .q Building Permit Confirmed ❑ Not Required ❑ CITY OF SAN JOSE BUILDING DEPARTMENT APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT Date-----------T...�------- - ------- 19(-ePermit No..---7..r...�? ... . The undersigned here�rye }]k(}�/Nglt�tor a the City of San Jose for a permit }o install p r s o as �Js�reverse side. Exemption from req uuemenf or Sfefe of Cali orn is for Contractor's License is hereby claimed by undersigned: as own � - p} J Undersigned attests that his State li a Co o i n is in full force end effect and properly or his p WIC San Jose City Business License $ �r'� — �O V-3/1 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 4911<E (tUv�JSTi972, ADDRESS / / 7 ,\ E�TL(JDD/� �yEJ USE OF BUILDING '-R>e-'� ACE PLUMBING 4EPVICE 396 Perrymount Br Corner of Stone Ave. FORM 2e0-30 rOm 1/6a Signed -------- SATT 1oso;-£a1ifornizr-4514+r--------------- 297-8107 1127 Kentwood Ace FIXTURES FIXTURES MAIN DRAIN Wafer Heaters / Floor Drains Size Material Water Closets Hoppers'- To 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 Washers Trailer Space Size 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 TOTAL jQD TOTAL FEE INSPECTOR'S REPORT HOUSE GAS PIPING Partial No. Lines Outlets Size Rough Tested and Approved Y