93703 (2) 7464 Fallenleaf Lane
Building Permit Confirmed
Not Required
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING. PERMIT .
Dafe l=/! ��.----/--j--- 19/,/ Permi+ No. -- L.. 7 ._.-......_:..
The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose
for a permit to install p bin fis r�ey�an / pi a list d reverse side.
Exemption from r ui o[ a} C or f ogf c}or's License is hereby claimed
by undersigned: es owner statement filed ❑
Undersigned a}}osis that is State of CGCCaifornia Contractor's License #
is in full force and effect and properly authise his applic '
San Jose City Business License # '///
I certify.}hat in the performance of the work for which this permit is issued I shall not employ
any person in any mann r so as to violate fho workm compensation laws of California.
OWNER 2��/ �,� 3
ADDRESS /���/ /vim-042F: �.G A� Lo+ No.
USE OF BUILDING
28030 Signe .. - - ----- ... . .. . .......
7464 Fallenleaf Lane Taylor, (John)
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 Wafer Leaders WATER SYSTEM
Dish Washers Trailer Space Size - Material
Waste Disposals Swim Pool FEES
Wash Trays ' Indirect Wastes Fixture Fee
Washing Machines Drywall Main Drain Fee
Water Treat. Equip. Backflow Preventer Storm Drain Fee
Sinks Survey Water Sys. Fee OL
Dental Units Gas Piping Fee
Drinking Fountains Survey _
Permit Fee a,
TOTAL G-Z,r {( ' TOTAL FEE 7, 'p
INSPECTOR'S REPORT -- HOUS GAS PI G
Partial 7 !9 .� �( A No. Lines Out Size
Rough /� �-�� , p, � , ��w -= Tested and Appr ed
Finish �_ _ By