HomeMy WebLinkAbout160 Mohegan Trail (3)DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT PERMIT#
Application is hereby:TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
APPROVED 1540 SULLIVAN AVENUE Bldg.Permit#
644-2511 ext. 230
Date Building Inspector
Application must be printed or typed
Loca 'on of Job.
FFEE SCHEDULE 60
1,000=$13.00
Tenant
treet No. Street Lot No.
Over$1,000=
13.00 per$1,000
or any fraction thereof Designation Apt.No.
APPLICANT 4- T
APPLI ANT ADDRESS /b-71 L
46J K-
APPLICANT PHONE# C
N S OWNER
OWNER ADDRESS 1LpC> 1— ,a 4,4 7
OWNER PHONE
C ESTIMATED COST$
IS THIS A CONTRACT COST? 13 Yes EHNo
dv
CJ FEE ENCLOSED$ J`
TYPE OF JOB:
OR-Co 0 New Installation
aAlteration/Addition/Repair Revised 8/99
APPLICATION FOR PLUMBING PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
RESIDENTIAL
BUILDING PERMIT APPLICATION? YES ElNO
BUSINESS CURRENT USE AND OCCUPANCY
ASSEMBLY
MERCANTILE FUTURE USE AND OCCUPANCY
EDUCATIONAL
INSTITUTIONAL ENGINEER'S NAME PHONEFACTORY
STORAGE ADDRESS
GARAGE
MIXED USE CITY STATE ZIP
Other please specify)
TYPE OF INSTALLATION e- pC-c4CIf UG 7 SIZE OF MAIN DRAIN 7
11
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
r ° S
wI,- eq
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.
CT-
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT DATE Cl °'—