HomeMy WebLinkAbout1200 Pleasant Valley RoadP RNIT N
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT li
Application is hereby : TOWN OF SOUTH WINDSOR
BUILDING INSPECTION DEPT.
APPROVED DISAPPROVED 1540 SULLIVAN AVENUE
644-2511 Ext. 230
ate ng Inspector Application must be printed or typed
i 1 . LOCATION OF JOB
gad Pisa IP Ad
FEE SCIIEDULE No . Street
0 - $19000 - 10.00 Floor Apt . No.
Over $1,000 - 10.00
2 . OWNER
per $10000 or
fraction thereof
3. ADDRESS J ZV O
x 6 fir}
4. APPLICANT
5. ADDRESS `fO rob, I:k D
6, ESTIMATED COST
7 . IS THIS A CONTRACT COST
Yee N
8. FEE ENCLOSED $ 16 _av
9. TYPE OF BUILDING:
RESIDENTIAL COMMERCIAL
i
10. TYPE OF JOB:
Original Installation
1GlClteration/Addition/Repair
RD 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11 . LOCATION OF JOB 60"I'I
NO. STREET APT. NO ,
e
12 . TYPE OF INSTALLATION
13 . SIZE OF MAIN FEEDER
14. NO. OF LIGHT LOOPS 15 . NO. OF HEAT LOOPS
16 . NO . OF POWER LOOPS 17 . NO. OF LIGHT OUTLETS
18 . NO . OF HEAT CIRCUITS 19 . NO. OF POWER OUTLETS
20 . NO. OF CONVENIENCE OUTLETS 21. NO. OF HEAT CIRCUITS
22 . NO. OF POWER CIRCUITS 23 . NO. OF LIGHT CIRCUITS
24. SIZE OF HEAT CIRCUITS 25 . NO. OF MOTORS
26 . NO. OF PANELS 27 . TOTAL WATTAGE
28 . NO . OF POWER FEEDERS 29 . NO. OF SWITCHES
30 . A/C LOAD 31. SIZE OF POWER FEEDERS
32. NO . OF FIXTURES 33. TOTAL HORSEPOWER
34 . NAME OF SUBCONTRACTORS AND THEIR TRADES
35 . REMARKS AND FURTHER DETAILS :
47
LICENSE NO.SIGNATURE OF APPLICANT DATE
PHONE NUMBER: ? G r 2 Q
IN6PEUTOR P - DATE TIME
LOCATION f-.TV4 Ilt
INSPECTION: CODE: RESULT(D/A) :
BUILDING:
ELECTRICAL:
PLUMBING:
HVAC:
OTHER:
APPLICATION FOR BUILDING PERMIT
Plumbing#
Electric# 12o PLEASANT VALLEY ROAD
HVAC # Date: /- 2 3 —9 g25737
Sprinkler#
FINAL R Estimated Cost r z,
Building i COMPLETE RED BOXED AREAS Permit Fee
Engineer TYPE OR PRINT ONLY Occupancy Fee
Affidavit SIGN ON REVERSE SIDE
Appr.for CO. I Total Fee
TO BUILDING DEPARTMENT,TOWN OF SOUTH WII`4DSOR,CT Additional Cost) $
The undersigned hereby applies to do work according to the following specifications:
Job LocationT,2 o o j52j lowr /} Lot No. Side of Street Zone
Applicant TeL#
Address Zip Lic.#
Owner ,~z4,q vci.T f Y L r TC 'Srh I Address f•a o o &c-5,SfAj ' LIA L PP
Architect Address
Sq.Ft.N w Area: 1st FI. 2nd FI. 3rd Fl. Total New Area
Rooms Lavatories Bathrooms Garages
Purpos of this permit: Ah r,J 6#i 1m.i g-Y ;oit l o o___S-vy E ' Ld&4q v Q1 =
City Water Well Septic System Sewer
Ins. H.O. t/ .P. Cert. Area I Basement Garage
Approved by 40 Date I Z'b 8 Use Group Construction Type
ReybW 1/97
I hereby agree to conform to all the requirements of the Laws of the State of Connecticut and the Ordinances of the Town of
South Windsor and to notify the Building Inspector of any alteration in the plans or specifications of the Building for which this
permit is asked,and agree that this building is to be located the proper distance from all street lines,side yard lines,and required
distances from all other zones and is located in which this building and its use is allowed.
Signed
I hereby apply for a Certificate of Occu cy for the work described in this application for the permit.
Signed
DO NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS