1973 (2) 7626 Hollanderry Place n
Building Permit Confirmed F4—�
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING; and/or GAS PIPING PERMIT
Dafe----------------- --�--------. 1973. Permit No.----------------1--�..7-�-----
The undersigned r by ma es appli 4ion 40 4he Plumbing Inspector of 4ha City o4 San Jose
for a permit To in all I 9 d rl'ryr6�on the reverse side.
Exemption from e e #at f i Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed
Undersigned attests that his a of California Contractor's License
is in full force and effect and pro er a rixes this pi a n-/��
San Jose City Business Licen
I certify that in the perfor ce of the work for which this permit is issued I shall not employ
any person in any manner so aa, to violate 1the workmen's compensation laws of California.
OWNER �� A! -h F' L/
ADDRESS Z[ 26 1k41-1q VbERk)1 PL. Lot No. 71
USE OF BUILDING6U)l MIAL6 P—OoL-
zeod0 Signed �✓ .. ._...
%{OG/illi9 /DOGS,
7F7F, Nnl1An79P-rrV PIRr`A Carolina
FIXTURES NO. FEE MAIN DRAIN
Water Heaters z I Size IMateriall
Water Closets To I Fee
Bath Tubs RAIN WATER DRAINAGE
Showers Size Material
Lavatories To Fee
Kitchen Sinks WATER SYSTEM
Diah Washer Size IMaterial
Neste Disposals Water Fixture Fee.
Nash Trays HOUSE GAS PIPING
Noshing Machines No. Lines Outlets
Nater Treat. Equip. Size Fee
Sinks FEES
Dental Units Fixture Fees <
Drinking Fountains Main Drain Fees
Floor Drains Storm Drain Fees
Hoppers Water Sys. Fee
Sand Traps Gas Piping Fee '3<%
Urinals Surve
Area Drains Permit Fee 2 r•
Nater Leaders I TOTAL FEE
116—ffb?-
Trailer Space INSPECTOR'S REPORT
Swim Pool Gas Piping
ndirect Wastes App roved,s% - 77>
)r well B y
Sackflow Preventer Partial
mrvey Approved '(S. 3
By
/
Rough
TOTAL Approved
B
Finish
Approved
B