85506 845 East Estates Drive
/ Building Permit Confirmed ❑
/ Not Required ❑
CITY OF SAN JOSE ' BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date '.d... ----------------------- 19 .967 Permit No.........,q 0 -'--...--'----
The undersigned hereby kes applicatio to th>c Pumbin�g��I!!jjpector of the City of San Jose
for a permit to install plu in f i s / pips s+ �Jrf jhe reverse side.
Exemption from ris e r at ntractor's License is hereby claimed
by undersigned: a owner' statement filed ❑
Undersigned attests that his State of California tfr,eters ��js55ane
is in full force and effect and properly au}horizes i ;Catiory7
San Jose City Business License # ��/ l� ', //
I certify that in the performance of the worr which this permit is issued I shall not employ
any person in so as /o fol fe the wo en's compensation laws of California.
OWNER=Q ✓�
ADDRESS /I `7�S Lot No /`6�
USE OF BUILDING
280 30 Avg. 69 Signed ---.... .... ... ..'---- ...
t�--..------
845 East Estates Drive Abatse
FIXTURES FIXTURES MAIN DRAIN
Water 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
Waste Disposals Swim Pool FEES
Wash Trays Indirect Wastes FixtaDrainFee
Washing Machines Drywell MaiWater Treat. Equip. Backflow Preventer StorSinks Survey WatDental Units Gas
Drinking Fountains Survey
Permit Fee
TOTAL TOTAL FEE
INSPECTOR'S REPORT HOUSE GAS PIPING
Partial n No. Lines Outlets Size
Rough / Tested and Approved
Finish By