HomeMy WebLinkAbout225 OAKLAND RD UNIT 100 DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT
PERMIT#
Application is TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
O!qrFROVE 1540 SULLIVAN AVENUE
644-2511 ext. 230 Bldg.Permit#
Date B ing Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job: �O d
F
: AKlef to b ag� IL.J$0-$1,000=$15.00 StreetOver$1,000=
$15.00 per$1,000
or any fraction thereof gnation Apt.No.
APPLICANT - �A-,nV I1fzOTtK2 S 1JC.
APPLICANT ADDRESS 1?O W es-r Nlc.t r, lS+f-e e-E'
APPLICANT PHONE#
SOW N S�q OWNER J,--\ C— .
OWNER ADDRESS Z� L tLrnMe�SLilce-f � .
Or OWNER PHONE g f aO
C ESTIMATED COST$ 3G(30 . O 0
►1 U
.� IS THIS A CONTRACT COST? _Yes _No /d
FEE ENCLOSED$
l��sO O�� TYPE OF JJ B:
$•C New Installation
Alteration/Addition/Repair
Revised 4/01//2002
APPLICATION FOR PLUMBING PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
BUILDING PERMIT APPLICATION? ❑YES ❑NO
❑ SIDENTIAL
BUSINESS CURRENT USE AND OCCUPANCY
❑ASSEMBLY
❑MERCANTILE FUTURE USE AND OCCUPANCY
❑EDUCATIONAL
❑INSTITUTIONAL
❑FACTORY ENGINEER'S NAME PHONE
❑STORAGE
❑GARAGE ADDRESS
❑MIXED USE
CITY STATE ZIP
(Other please s)ecify)
TYPE OF INSTALLATION_a^�.¢ GR 0 u.v� ky#.6' OF MAIN DRAIN
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 S)n e- S
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
THE UNDER IUNED 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.
zo3-fzG P- 1 CT
CONTRACTORS LICENSE NO. E STATE
SIGNATURE OF APPLICANT DATE
Electric # APPLICATION FOR BUILDING PERMIT
Plumbing# 225 Oakland Road, Building 100 Date: 25 Q
HVAC # -1 ��v f
Sprinkler# 3 2621 FINAL APPROVALS � - - ---- -------- -- ----- — --- - Estimated Cost $ � ap p
-- --------- -- -- ---- — ---- Permit Fee $
Building --
j COMPLETE RED BOXED AREAS Occupancy Fee $ /
Engineering vit TYPE OR PRINT ONLY Eng. Insp. Fee $
Appr. for CO. - ► SIGN ON REVERSE SIDE ,Q
PP - - - -- - - -- -- Total Fee $�/ U.
TO THE BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR, CT (Additional Cost) $
The undersigned hereby applies to do work according to the following:
Applicant EA Location of Work 22. O L A4\J . Lot No.
Applicant's Ad ress Vjkj M Je SDI G�f Tel.# (dJ Zf
Town 14-4 d�Y GT_ Zip L-c.# tl
Owner c-/1 t,� �k A. awe - Architect I
Owner's Address Architect's Address i4- i_
Zip Zip
Sq. Ft. New Area: 1 st FI. 2nd FI. 3rd FI. Total New Area ec"O
Purpose of this permit
( I N !
City Water Wello" Septic Systemo SeweX_
Ins: HO SP Cert. Area Baseme Garage
Approved by _Date Use Group Construction Type
Revised 6M2
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 u all ed.
Signed
I hereby apply for a Certificate of Oc y for the wo k descri in th s application for the permit.
Signed
DO NOT WRITE BELOW THIS LIN
INSPECTION COMMENTS