76770 7639 Prospect
1D Building Permit Confirmed, ❑
Not Required ❑
CITY OF SAN JOSE 1 BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
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Permif No.---
The
undersigned here ekes ap lication to the Plumbing Insp of the City of San Jose
for a permit to install u f' re / ip e } v se side.
Exemption from r a nia ra s License is hereby claimed
by undersigned: as owner statement filed ❑
Undersigned attests the his State of Cali rnia Contractor's License #
is in full force and effect and properly auihor' a R'-dpp is •ffi
San Jose City Business License # ���� /J1
I certify that in the performance of the arkor which this permit is issued I's'gall not employ
any person in any mann r o as to violat the workmen's compensation laws of California.
OWNER
ADDRESS]
USE OF 8U DING
FORM 260-30 10M 1/68
Signed.- -
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7639 Prosppect Ezag' —aH Cr
FIXTURES FIXTURES MAIN DRAIN
Water Heaters Floor Drains Size �/ Materia
Water Closets ,j Hoppers To To Septic Tank
Bath Tubs Sand Traps R WATER DRAINAGE
Showers Urinals Size Material •-
Lavatories 2� Area Drains To Curb To Main Sewer .
Kitchen Sinks Wafer Leaders WATER SYSTEM
Dish Washers Trailer Space Size !� Materia
Waste Disposals Swim Pool —7--FEE$ r
Wash Trays Indirect Wastes Fixture Fee l p
Washing Machines Drywell Main Drain Fee v�
Wafer Treat. Equip. Backflow Preventer Storm Drain Fee
Sinks, Survey Water Sys:' Fee did
Dental Units Gas '
Piping'. Fee
Drinking Fountains Survey
Permit Fee moo
TOTAL TOTAL FEEqF L7,9 Q
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial
Kough No. Lines Ouflefs Size
Rough�_��j.�40 Tested and Approved
Finish By