89877 (2) 7.851Orion Lane
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date---./ .3----70. 19------- Permit No.---.- 9 7-7----------------
The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose
for a permit to install plumbing fixtures and/or pipes listed on the reverse side.
_ Exemption from requirement for State of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed Q
Undersigned attests that his State of California Contractor's License #CSV 6t�.o� 557_
is in full force and effect and properly authorizes this epplication �//(j 71 7�
San Jose City Business License
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
ADDRESS % %(/ Lot No.
USE OF BUILDING
280 30 Signed ---—........
7851 Orion Lane �/ AAA Plbing Company
FIXTURES FIXTURES MAIN DRAIN
Water Heaters Floor Drains Size Material
Water Closets Hoppers -fo`—j To Septic Tank
Both Tubs Sand Traps RAIN WATER DRAINAGE
Showers Urinals Size Material
Lavatories Area DrainsTo Curb To Main Sewer
Kitchen Sinks Water Leaders WATER SYSTEM
Dish Washers Trailer Space Size Material
Waste Disposals Swim Pool FEES
Wash Trays In irect Wastes Fixture Fee
Washing Machines D ell Main Drain Fee
Water Treat. Equip. Ba kflow ent Storm Drain Fee
Sinks Sur Water Sys. Fee
Dental Units Gas Piping Fee
Drinking Fountains
Survey
Permit Fee
TOTAL TOTAL FEE /
INSPECTOR'S REPORT HOUSE GAS PNG
Rough
/- I INo. Lines Outlets Size
Rouughgh — - Tested and Approved
Finish By