HomeMy WebLinkAbout1 Amaryllis Lane (5) PERMIT NO.
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DEPARTMENT DECISION APPL ICAT ION FOR
Application is hereby : PLUMBING PERMIT
TOWrl OF SOUTH WINDSOR
APPROVED DISAPPROVED BUILDING INSPECTION DEPT.
q 3 ray 644-2511 Ext. 230
Date Building Inspector Application must be printed or typed.
1. LOCATION OF JOB: �MAtZY�L�S I.A IJ�
FEE SCHEDULE 2. OWNERN'bm
3. ADDRESS:a01 -10,
i $ 0 - $1 , 000 - $10. 00
Over $1 ,000 - $10. 00
per $1 ,000 or 4. APPLICA
fraction thereof
5. ADDRESS:
,ko,aAiao In CTQ&any
6. EST. COST: $
7. IS THIS A CONTRACT COST? V YE �NO� -
8. FEE ENCLOSED: $
9. TYPE OF BUILDING:
�SIDENTIAL COMMERCIAL
10. TYPE OF JOB:
,/ ORIGINAL ALTERATION
INSTALLATION ADDITION
' REPAIR
BD 2A 11/88
APPLICATION FOR PLUMBING PERMIT (Cont. from Reverse Side)
11. LOCATION OF JOB: - "-`/ 1�h bbt z-j �("
GENERAL PLUMBING
cc,'\P ke-�
12. KIND OF INSTALLATION: 1(1C W Ir 0llSC 13. SIZE OF MAIN DRAIN 3��
14. NO. OF TOILETS CP% STYLE �•�C�J�Q 15. NO. OF URINALS STYLE
16. NO. OF BATHTUBS_ 16A. NO. OF SHOWERS - 17. NO. OF LAVATORIES 3
18. NO. OF SINKS_ 19. DISPOSAL_ 19A. DISWASHER
20. NO. OF CONDUCTORS SIZEfl /�R 21. NO. OF STACKS_ SIZE 3 ��
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 3l / 31A. SIZES OF WATER PIPING & RISERS J�y ////
32. REMARKS AND FURTHER DETAILS
WATER HEATER
33. TYPE 34. MANUFACTURER
TANKS SAFETY DEVICES
TEMPERATURE
35. CAPACITY 39. RELIEF VALVE
36. TEST PRESSURE LBS. 40. MANUFACTURER
37. WORKING PRESSURE LBS. 41. PRESSURE RELIEF VALVE
38. TYPE 42. MANUFACTURER
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LICENSE NO. DATE SIGNATURE "OF APPLICANT
PHONE NO. (Q7,;?--78q,7