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72228 7639' Pro pact: Pd r - 1101dingl Permit Confirmed!0) Nbt Regui"redi' CITrY' OF''SAN JOSE` BUILDING DEPARTiMENT LI/ATI I FOR PLUMBING and/or G AS PIPING PERMIT'APP Dai . . e.,_- • ,��. ........... The undersigned: here'b ' ekasl epplicatiom•to fhd. - Bing Ins - r-of the City'of'Sam Jose, for a permit to install' _ - ii� i -I' a ,a e••- verse side.. - `� 6amption,&or r r ar on ractaFs Libense is hereby:cliimed• - �4:' by undersigned:: s'� owner ❑ statement-filed 0' Undersigned attests that . State of Cal• Ern Contractors ns`a� '.•'. '��3y—`c�(��-7—� 7 as,m folio force and,eff.usinei and' properly eutT app icefio Jib W0+- San.,Jose Crfy Business kieenso # {,'C6I 1' certify that in the performance of'fhe.wor or which is permit:-is,,mese.II shat employ any person in any..mann" 6 as',to viola the workmenli:,co"mpvmation.Iewvof'California: OWNER'- ADDRESS USE- OF BUILDING FORM.2B0-90 IOM 3/6T Signed .�y1�------ _ _ __ -_ _.._..--=_------- 1 7639 Prospect rd: Crown ,tel 7639 Proajkect - Building Permit. Cbnfirmadf�- Nof Requitedi 0 CITY OF-SAN JOSE BUILDING DEPARTMENT APPLICATIO/N .FOR PLUMBING avid/or GAS PIPING PER MIT Date.------_-f 1' 1G�---------------- 1.9x1_:7 Permit Ndr - — -s ---•---- The undarvgneil'.,her y makes. ap '.ie,a�tiQt''/m�/toJ;the Plumbing Ins aetor of the City of San Jose far a permit to .instal' plo i •r! IeGdQt Ga11p tv reverse aide. { Examption from a r rector's Libense is hereby claimed'• • 6y undersigned as. owner ❑ statement filed 0 q �O.��D7 - Undersigned attests that his State of Calify nia Cdnfraetor's License i ' is in,full force and effect and properly authoii[ ss/apJ/af o/n/ San Jose City Business License e# /Y---'�� Ly�-�-`e"T'^_'L`�`� _ I certify that in tfie,p ormence of the work for which this permit is issued I shall not employ - any person in any an to viola :workmen'i.'compensatidp laws.of California. ,OWNER ADDRESS 'USE OF BUILDING ' FORM 280-30 IOM 3/67 I Signed ..:... ..... k.. 7639 Prospect ' FIXTURES FIXTURES ;r i MAIN DRAIN i Water Heaters Floor Drains Size Material' Water Closets Hoppers To - -. To Septic Tank. Bath Tubs Sand Traps RAIN WATER DRAINAGE:_ Showers UrinalsSize Mater ief Lavatories Area Drains Toy Curb T,o fin.Sewer; Kitchen Sinks Water Leaders WATER'SYSTEM Dish Washers Trailer Space Size -1 M'ateriali Waste Disposals Swim Pool FEES' Wash Trays Indirect Wastes Fixture Fee Washing Machines Drywell ° Main Drain.Fee Wafer Treat. Equip. Backflow Preventer Storm Drain Fee Sinks Survey Water Sys.. Fee _ iDental Units Gas Piping Fee Drinking Fountains Survey Permit Fee TOTAL TOTAL FEE INSPECTOR'S REPORT HOUSE GASPIPING Partial r No. Lines Outlets Size. •Rough /Z 11LI �^ Tested and Approved - I Finish / By l • FIXTURES FIXTURES _ MAIN DRAIN Wafer Heaters Floor Drains Size t. Material _ Water Closets Hoppers To To C--.:. T--6 Bath Tubs Sand Traps RAIN WATER DRAINAGE! Showers Urinals SizeMaterial Lavatories Area Drains To Curb I To Main Sewer Kitchen Sinks Wafer Leaders WATER SYSTEM Dish Washers Trailer Space Size Material Waste Disposals Swim Pool ..FEES Wash Trays Indirect Wastes Fixture Fee G Washing Machines Drywell Main Drain Fee Wafer 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 _ INSPECTOR'S REPORT HOUSE GAS PIPING Partial _ _ No. Lines . Outlets Size Rough / / L. .�7•' Tested and Approved Finish 9y 7639 Prospect Rd r Building Permit Confirmed ❑ r Not Required ❑ CITY OF 'SAN JOSE BUILDING DEPARTMENT APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT Date.....(F-/ I No. The undersigned hereb makes application to +ha robing Ins ct r of }he City of San Jose fore permit to install m ' ix i I' e o e verse side. Exemption from r 4 r or on Factor's License is hereby claimed by undersigned: s owner ❑ statement filed ❑ Undersigned attests that is State of Cal' rota Contractor's nse # is in full force and affect and properly au}h isui applica+io . San Jose City Business License # / 1 certify that in the performance of }ha wort for which KisiperrinTf is issue I shall' of employ any person in any mann ' o as to viola the workmen's compensation laws of California. OWNER ADDRESS USE OF BUILDING FORM 280-30 IOM 3/67 Signed.. .-. ....... -_....--._..... 7639 Prospect rd Crown FIXTURES FIXTURES MAIN DRAIN Water Heaters Floor Drains Size Material Wafer Closets Hoppers 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 I 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 TOTAL FEE ` INSPECTOR'S REPORT HOUSE GAS PIPING Partial 11 _.t No. lines Outlets Size Rough / /L�/� Tested and Approved Finish ' - �� By