HomeMy WebLinkAbout10 Debbie Drive (3) DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT
#
TOWN OF SOUTH WINDSOR PERM>*r
Application�s hereby: BUILDING DEPARTMENT
(2PROp
1540 SULLIVAN AVENUE Bldg.Permit#
402— SAL, 644-2511 ext. 230 �� =
ate Building Inspector
Application must be printed or typed
Location of Job:
FEE SCHEDULE i
f� �66 q.- Dr f 0
$0-$1,000=$13.00 Street No. Street Lot No.
Over$1,000=
$13.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT fZc 6e-r_" GCWerArA)
APPLICANT ADDRESS (4 �
50
APPLICANT PHONE#
oil�OWN S�q OWNER
OWNER ADDRESS �1►'1'�-
OWNER PHONE s
ESTIMATED COST$ �t SCE a
V
IS THIS A CONTRACT COST? 13 Yes 13 No
G FEE ENCLOSED$
TYPE OF JOB:
O •C
{{ G New Installation
i
Alteration/Addition/Repair Revised 8/99
APPLICATION FOR PLUMBING PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
BUILDING PERMIT APPLICATION? ❑YES ❑NO
❑RESIDENTIAL
❑BUSINESS CURRENT USE AND OCCUPANCY
❑ASSEMBLY
❑MERCANTILE FUTURE USE AND OCCUPANCY
❑EDUCATIONAL
❑INSTITUTIONAL ENGINEER'S NAME PHONE
❑FACTORY
❑ STORAGE ADDRESS
❑GARAGE
❑MIXED USE CITY STATE ZIP
TYPE OF INSTALLATION SIZE OF MAIN DRAIN
NO.OF TOILETS STYLE NO.URINALS STYLE
NO.OF BATHTUBS NO.OF SHOWERS NO.OF LAVATORIES
NO.OF CONDUCTORS SIZE NO.OF STACKS SIZE
AREA OF ROOF NO.OF CATCH BASINS NO.OF FLOOR DRAINS
NO.OF OTHER FIXTURES KIND
ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW ❑YES ❑NO
SIZE OF WINDOW IF NONE C.F.M.OF VENTILATOR
SIZE OF DUCTS SEWER OR SEPTIC TANK
SIZE OF WATER MAIN SIZE OF WATER PIPING&RISER
WATER HEATER: TYPE MANUFACTURER
DESCRIPTION OF WORK
p
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO
COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
4zyllt 4e oWA e�
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT DATE
02l25/2002 15:26 8607498021 MIKES PLUMB & HEATIG FADE 01
AHaET Pdambing&Nam,LLC
44 N'US*w CYrrk i DATE
ERfW4 CT OW2 - f
86&74"021 f 2/25l02
NAMEIADDRESS
Robert GoldeatW '
10 Debbie Dr.
South,Whl&orft 06074
DESCRIPTION
t
On 2/19102 we inspected the plumbing work done in the bent remodel at
10 Debbie Dr. South Windsor.All wo*doge was found to be satisfactory and f
to applicable buildimg code.
If there are any queastions regarding this matter please contact us at
%0-292-6570
i
Q.License Type P1 #204136 Phrding f
I Ct.License Type S3 0309913 Heaft
+ � I
f
i
' 1
f
SIGNATURE
rR r
MOULTON ELECTRIC JOB INVOICE
FOR THAT"HOT"ELECTRICAL WORK
37 WEST STREET
MANCQH/EESTcER, CST+ 06040 °�" , /
(2!645-116rJ ORDER TARF97ff DATW POKWISED A.M.
U C 4/91 Q P.M.
BILL T / PHONE
ADDRESS r MECHANIC
CITY HELPER
JOB NAME AND LOCATION
CKDAY WORK
ORSCRIPTION F WORK Q CONTRACT
❑ EXTRA
/ v J y
rj f�: ( F� / LT ems' •/v ! p
QUANT. DESCRIPTION OF MATERIAL USED PRICE AMOUNT
I-If
r
f � , _� ,•� T r
.Z
i,
,
.���... / ,
" n 1
47
MOURB LABOR AMOUNT TOTAL
MECHANICS �', � @ i MATERIALS G'
HELPERS @ TOTAL
LABOR
I hereby acknowledge the satisfactory TOTAL LABOR
completion of the above described work:
SIGNATURE DATE COM►LETEO TOTAL ( /
ti �