305 1333 Primrose
Building Permit Confirmed ❑^ �
Not Required Lam'
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
// - z,j
Date...... - ---------- .. ... I .. P/erfljlrt) N � - ------ -
The undersigned hereby applica ion'Ro�lhesPlurs�bin'g'Inspector of the City of San Jose
for a .permit to install plumbing fillures and/or pipes listed on the reverse side.
Exemption from requirement for State of California for Cont�ctor's�L,ii enseeis• er by claimed
by undersigned: as owner ❑ s!a akd
Undersigned attests that his State of Califog�Contracf4'License #
is in full force and effect and properly authorizes this application.
San Jose City Business License # //'.3 _ 67E7H'
1 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 CO3/2le,1L/CL4. `TA —
ADDRESS /,3 .3 -3 Lot No.
USE OF BUILDING /
28040 Signed ------------S----- ----
1333 Primrose Ace
FIXTURES FIXTURES MAIN DRAIN
Water Heaters A Floor Drains SizeI Material
Water Closets i Hoppers To I 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 Op
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 __2:__,_,c
-TOTAL TOTAL FEE oO
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial No. Lines Outlets Size
Rough Tested and Approved
Finish By