HomeMy WebLinkAbout19 Ann Road (13)4
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APPLICATION FOR PLUMBING PERMIT (C ntinued tr m Reverse Side)
TOWN OF SOUTH WINDSOR, CONN.
11. LOCATION OF JOB q A/
NO. STREET FLOOR APT.00.
DQ jGENERAL PLUMBING
12. KIND OF INSTALLATION 13. SIZE OF MAIN DRAIN
14. NO. OF TOILETS STYLE 15. NO. OF URINALS STYLE
16. NO.OF BATHTUBS 17.NO.OF LAVATORIES 18. NO.OF SINKS 19. NO. OF WASHTUBS
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 n1i D
20. ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW?27. SIZE OF WINDOW
28. IF NO WIND W.WHAT KIND OF VENTILATION IS THERE?
29. SIZE OF DUCTS 30. ARE SEWAGE AND WATER FACILITIES AVAILABLE?
SIGNATURE ADDRESS 3F /Id euR/ ;4 lt'z b
LICENSE NO. c;163 ESTIMATED COST TELEPHONE o 3
OWNER 25; A"I'Ve ADDRESS 74,<('
WATER HEATER
31. TYPE 32. MANUFACTURER
TANK SAFETY DEVICES
33. CAPACITY 37. TEMPERATURE RELIEF VALVE
34. TEST PRESSURE 38. MANUFACTURER
35. WORKING PRESSURE 39. PRESSURE RELIEF VALVE
36. TYPE 40. MANUFACTURER
ALL WORK COVERED BY THIS APPLICATION HAS BEEN AUTHORIZED BY THE OWNER OF THIS PROPERTY
AND WILL BE DONE IN STRICT ACCORDANCE WITH THE BUILDING CODE.
C0962 DATE SIGNATURE OF APPLICANT