84962 932 Ferngrove
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date........- _ ' 91 ...� i2:??/ J !'� (�����P.. .................
The undersigned hereby makes applica}ion to the Plumbing Inspector of the City of See Jose
for a permit to install plumbing fixtures d/ ipasd
Exemption from requirement for S alifor a ntM io e e is hereby claimed
by undersigned: as owner statement filed Cl
Undersigned attests that his State o alifornia Contractor's License #
is in full force and affect and properly authorizes this application.
San Jose City Business License #
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 aceto violate the workmen's compensation laws of California.
OWNER
ADDRESS 93Z Lot No.
USE OF BUILDING—
Signed
UILDING
28030 Aug.69 9 �/ //v-�✓%Lr/ '.......'�^ .
........._.........
Si ned .... � ....
932 Ferngrove G. Hunisker
1
FIXTURES FIXTURES MAIN DRAIN
Wafer Heaters Floor Drains Size Material
Wafer 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
-Vaste Disposals Swim Pool FEES
Wash Trays _ Indirect Wastes Fixture Feea�
Washing Machines Drywell Main Drain Fee
Water Treat. Equip. Backflow Preventer Storm Drain Fee
Sinks Survey Wafer Sys. Fee
Dental Units Gas Piping Fee
Drinking Fountains Survey
Permit Fee
TOTAL TOTAL FEE" j- Q
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial
Rough No. Lines Outlets Size
� Tested and Approved
Finish - 4-7�- Q - By