HomeMy WebLinkAbout100 Bidwell Road (32) PERMIT NO.
X5�9a
DEPARTMENT DECISION APPLI CAT ION FOR
Application is hereby : PLUMBING PERMIT
TOWM OF SOUTH WIND SOR
APPROVED DISAPPROVED BUILDING INSPECTION DEPT.
`c 11-,�5 644-2511 Ext. 230
Date B ing Inspector Application must be printed or typed.
1. LOCATION OF JOB:
T
FEE SCHEDULE ZI O u �f" trAti
2. OWNER:
Z.E• H RRP oc SG LL)onvAl Y
$ 0 - $19000 - $10.00
3. ADDRESS: JV*P4T7'EIZ S
Over $1 ,000 - $10.00 / AAZ-P-Q&b C.1 D(o(b(
per $1 ,000 or 4. APPLICANT: 1,z AP&
fraction thereof ����� Go
5. ADDRESS: X&O Al W &,'rl
Ir
/yR/y'/iP>
00
6. EST. COST: $
7. IS THIS A CONTRACT COST? YES NO
8. FEE ENCLOSED:
Lt
9. TYPE OF BUILDING: ZCOMMERCIAL
RESIDENTIAL
10. TYPE OF JOB:
ORIGINAL 11 ALTERATION
INSTALLATION ADDITION
REPAIR
BD 2A 11/88
APPLICATION FOR PLUMBING PERMIT (Cont. from Reverse Side)
11. LOCATION OF JOB: /DO /3/dLs/E.CL V lT_ &-"/wz4p
GENERAL PLUMBING
12. KIND OF INSTALLATION: 13. SIZE OF MAIN DRAIN
14. NO. OF TOILETS / STYLE 1KX- 1( 15. NO. OF URINALS STYLE
16. NO. OF BATHTUBS 16A. NO. OF SHOWERS 17. NO. OF LAVATORIES /
18. NO. OF SINKS 19. DISPOSAL 19A. DISWASHER
20. NO. OF CONDUCTORS SIZE 21. NO. OF STACKS SIZE
22. AREA OF ROOF 23. NO. OF CATCH BASINS 24. NO. OF FLOOR DRAINS
25. NO. OF OTHER FIXTURES KIND
26. ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW?
27. SIZE OF WINDOW
28. IF NO WINDOW, WHAT KIND OF VENTILATION IS THERE?
29. SIZE OF DUCTS 30. SEWER OR SEPTIC TANK?
31. SIZE OF WATER MAIN 31A. SIZES OF WATER PIPING & RISERS
32. REMARKS AND FURTHER DETAILS % �,�y0�/,tr ,t',Y/"A-'C
WATER HEATER
33. TYPE 34. MANUFACTURER
TANKS SAFETY DEVICES
TE1 PERATURE
35. CAPACITY 39. RELIEF VALVE
36. TEST PRESSURE LBS. 40. MANUFACTURER
37. WORKING PRESSURE LBS. 41. PRESSURE RELIEF VALVE
38. TYPE 42. MANUFACTURER
709
LICENSE NO. /- DATt SIGNATURE OF PLICANT
PHONE NO.