13099—/ Building Permit Confirmed 0,
Not Required
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
/ — /
Dafe-------/---70---------. 192 Permit No.-------/--- J-19--------------
The undersigned hereb kes ice ' n the robin ector of the City of San Jose
for a permit to install pl b' re pip li� reverse side.
Exemption from requ at a i rni C Factor's License is hereby claimed
by undersigned: s owner ❑ statement filed ❑�&.� X3.1 C 3
Undersigned attests that his State of lif��jjPPia Cojac or's License #
is in full force and effect and properly a4� 4hi�ItJti�n. /��jyJw
San Jose City Business License #—{' / (��f�Q60`T"
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 as to violate the workmen's compensation laws of California.
OWNER I Izi kIZ-A 4�')r
ADDRESS S�� FS /7�'e+N1vjSP027- V/L Lot No.
USE OF BUILDING ES
280-30 (9-73) Signed .tom --.,L� (�----------
i
8085 Hyannisport Ana
Water Heaters I / I/,00 I Size IMaterial
Clos
Size
Kitchen Sinks
WATER SYSTEM
Di5h Washer
Size IMaterial ,
Noste Disposals
Water Fixture Fee
Nash Trays
HOUSE GAS PIPING
Vashing Machines
No. Lines Outlets
Yater Treat. Equip.
Size Fee
Sinks
FEES
Dental Units
Fixture Fees roo
Dri nkin Fountains
Main Drain Fees
Floor Drains
StormDrain Fees ,
Hoppers
Water Svs. Fee
s
Area Drains
Permit Fee2—(00Nater
Leaders
TOTAL FEE I 7,00
Trailer Space
INSPECTOR'S REPORT
>wim Pool
Gas Piping
ndirect Wastes
I Aooroved
r
Finish