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HomeMy WebLinkAboutPermit Plumbing 1989-6-13 r InSPECT lUll L1iH. 726-3709 Job Address (;.:!J2 ~.#/# I.eqal Oe~cription ?wn~r. ~C:-?? /5:),1;" rc '__"~L ~ ~h,.,./};~ . .\Mress 4/4/8);>j '"?...... C::;;V~2:;. 4::i". - ". Construction lender ,\JJrcss llt5 fI /1 lid me Primary Structura I Electrical !1echanical CONTRACTORS LIlY III SI'f1llllif I llU CO/IBIl/MION APPliCATION/PERMIT E!/ERGY SOURCES: Ileat Hater IIcater Ranl1e. Va I~' of H.'''''- ,:IS' ~.-:c ~ ~ \J) Bui It;inCl lermi t Info: Describe Hark( i.e.. Oui Id Single II ~ f.lr.lilv f!es enc(' \lith J\ttached r.araoel 'J .4~~"'c ; fiR. :":. :~. <; ? /,:!:.....y__~ 'OV1/M t/ &<:=-/" z> ;:c;c~C?_ .....-;.-A<::c.........?::5 LEAi 'e 1 ics. no. '<:;7': -,,/~l.O~/~ &'j'"?Y-'-'" ,- -~- - - flfOR/IAT; .:1 ll..:. 716-3753 Sa. FlQ. I':ain ~CJ. rtf). Access. SQ. Ftq. Other lIel1 Add Aller ~eD. --rence Demo Change/Use -Other -- -- no. I Phone address (cxoirE's \ I . i I I I I I \.Ihlme , (Ilhone no. ) I / I I I I 1-1...--. I I I I I I I I I I TOTAL CHARGES ~ ~ -6".... TOTAL CHARGES HIIWE STATE L.ill R[QUII~(S that tile Electrical work be done by an shall not be v"lH until thl1labcl has been silJned by an Electricill Genera 1 Plumbino .0~5 ?CL;//?7i!!Q~ Electrical ;r'~..".,.,..< T> ") C"LFe/ \ tlcchitnical PlUlIfiI IlG ::0. -IlL CIIARGE ? E~~~e fi~.tu::: ?-.5P <'2.; _J W~~_~ IRelo-ca~ted buildilH] (new fix. additional) l.s.F. r.esidence r I bathl -IOuPlex (I bath) oach IAdditional bath I ~!ater service I Sewer I Storm Sel'ler -I I I I I I I Zone Fire lone Flood Plain BUllOII/G PERIIIT Chitr']es an~ Surcharges I Floor furnace ::s".::l..9 . and vent I I Recessed wa 11 ,_ ~e...l1ill.er and I I I I I I I 'I I I I I I I I I I ~ '<?&> I TOTAL CIIARGES (address ) ELECTRICAL .lID....... Residence of SQ. Fr. ~INew circu~ts alts. or extenSions ? &1:F( ~~& /SERVICES -, I Temporary Construct ion IC'lanqe in existing r('.<;; d~nr~ Imultifamily, con~. or I nrille; tri.~ I IOf ICor~I.!INO. FEEDERS II ns ta II /a I tel"/re locate rlie;trih_ f('prl('r<; IOf amps. I I I I I I amps./ I I { 1 ics. no.) 1- ..ilL .CIIARGf. .JIl!.... flECllANICAl I.HL .CJIARGL . I / v+ I I I I II I I I I I I furnace/burner to BTll's I Apoliance vent <;'PO<lI'a,tP I Sta'tionary evap. cooler I Vent fan \~ith sinnle duct. I Vent system apart from I heatin~ or A.C I ~lechanical exhaust hoorl .Ind rl',r t. I Hood stove/heater I I I I SSIIANCF OF PFmll T Electrical Contractor. the electrical portion of this per~it Supervisor and returned to the Building Division I Plan Ck. Comm/lnd ____________ 6S!/BldQ Per ~pp Plan Ck. fles JO%/Bldo Per Fee ~ ~ -So. I Fence -----/--;-3--1 Demo ~?-S-C>.. I Sidowalk ._n_/~/_;_-:-1 A/C Pavinq I Curb Cut I IIAVE CAI!EFULlY [xN1JrI[i) t~lc completed apf11ication for flermit, clnd do hereby certify that all information hereon is true and correct. and I further certify that any and all \~ork nerformed shall be done in accordance with the Ordinances of the City of Soringfield and the Laws of the St.lte of Drenon nert(1ininC) to the work'descrihed her.ein, and th<1t UO OCCl!PAIKY \~i 11 be made of any'structure without the permission of ' the Bllilclin~ Oivision. I further certify that illY re!listration ...lith the Builder's Ooard is in full force ,lnd effect as required by OI~S 701.055, ttl.lt if cxelllot the basis for exemntion is'noted hereon. and that only subcnntr,lCtors and orn~lop~~JO iKRO~iL with O/'S 7"1.0S5 ,ill I be usod on this nrojocl. lIA:IE(please ~rlnt) U -:J 11//_ . SIr.r/^TURE -~J' t1-< V FO~ nrFI[~ IISE O:lLY . Tyoe/Const. \Jnits Sf'!. HfI. '\ain Bedrooms Occy load SQ. Ftrr. Access Stories Occ.v Group 51'}. rtg. Other Plu'm ING PERMIT C~arges ilnd Surcharges . ([[CTRICf.l rERf:IT CharQCS and Surcharges I1EClIAtlICAl PEP.lllT Charges -and Surcharl")es ------------ I I I I I I I i//J/ a) x Value Value x Value TOTAL VAlOATIOll x Systems Oevelopment I Char"e (1.5') I I I I ITotal (omb. rermit I TOTAL '17.26 '-l - . p COMBINATION APPLlCATlON/PfRMIT (CAP) PERMIT VALIDATION J ,', . I .. " I. Applicant to furnish .A. Job Address B. Legal Oescription 1. example. Tax lot 100. larie County Map Reference II OJ oJ 2. eXclmnle- lot t. Block 3, 2nd Addition to-- ~prln9fjeld Estales Name. ctc.,of owner 'and construction lender Energy Sources _ , 1. exam,!le-'heat/electri~~.! ceilin.:!/or forced air Qas Z. examele- waterheater{t!II!ctr-1Cil1/or solar t." Square rootage or valuation: elc-. - 1. examale- J250 sq. foot house, 500 sQ. foot garage .~.: exarup'le. if new project. checknew _ if addition, Check add, etc. F. Building permit information: J. examole - construct sinyle family house with an attached 9olr~ge 2. examale - remodel existing garage into family room 3. exanlllle - COuvert single filllJily residence into restaurilnt (change of use) G. Villue of ""ark as defined in Section 303 (a) of the Structura 1 Spec iillty Code H. Of SIGN TfNI ANO COIITRACTORS To avoid design or consl,.uclion 'delays, Builditlg Division Staff must be able to conlilct appropriute persons regarding design infonmation or job site corrections, etc. Abbreviated Plumbing, Nechanical, & Electrical Schedules A. Except ,.,here blank, spaces occur in the description portion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacent to the appropriate 1tem(s) to be installed B. Full Plumbing. Nechanical, and Electrical Schedules are available at the Building Division 1. To conserve space on the permit form the SChedules have been abbreviated 2. If the item(s) to be installed are not covered on. the abbreviated schedules you should consult the full schedules C. BUILDIIIG OIVISION STAFF I/lLL FILL OUT ALL FEES AIID CHARGfS 011 Tllf SCllfUULES D. As noted on the CAP, the label must electrical contractor for signature supervisor. The general contractor to sign the electrical label. Applicant to sign and dale Whenever possible, the initial application will be used as a worksheet only. Where Possible, Bui Iding Division Staff wi 11 prepare a type wri tten copy and return it to the applicant al the time the actual permit is issued for his s igndture. Fees and Charges Plan check rees are due and payable at the time of the application, and no plans Nil} be processed until these fees are paid. All other fees and charges are due i1nd payable when the permi t is issued. .c. '. '0. .,.-.. II. be de 1 i vered to the by his electrical is not authorized Ill. IV. V. FOR OFFICf USE OIlLY , . , ~.~ \D'\J " Pernri t. Cl"~ , I J PROJECT CONDITIONS TO BE SI)TISFIED BEFORE OCCUPAtICY: " ~~"'~ ~-~vc.7-~-r"::;~~"S-YJk:.~ ._:- ..c:s:l~~ .:;<. . Gt;..>/,,7>..4>~.r L;;W/O__...d;.... ,0 ,-",,<'L~('A:' 5'~/;:?P-7'J:~,..c- ~ C/ry /g>~-=~.z>t=; 7._':"__2'/~_ ..(&~~~i , , 'I A4w.,.../"",- "sH,.9.::..<..?& I Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name /.-,-:;7~ h=-....,~ signature //..,_. -, ~ I ~ d: ~ da te ?; -/7-89