HomeMy WebLinkAboutPermit Plumbing 1982-01-14INSPECIION I,tNE
72&3769
INFOTMATION I,INE
7263753
CIIY OF SPRINGFIETD
COME!NATION APPIICATTON/PENiIII
4
s3
[egol
ENERGY SOURCES:
Woter Heoler
Heot
Volue of Work:
Sq. Frg. Moin
--
New.-Add-Alrer-Rcp.
- -Fence-Demo-Chonge/Usa
Other
Sq. Ftg. Accesr.
Sq. Ftg. Other
Deseribe Work (i.e., Build SingleBuilding Permit ln{o:
Attoched GoFomiPhoneAddressZ
nde r
\
Address Phone
(lics. no.)(oddress)DESIGN TEAM (nome)
MECHANICAT
ETECTRICAL
Mechonicol exhousl
PTUMBING
CHARGENo.CHARGErEE
Residence
from
I
ond
s.t
Eoch si fixture
Relocoted bui lding
Vent
Electricol
Mechonicql
furnoce/burner lo
Applionce vent
Residence of
fr.
New circuits, olterotions
or exlensions
SERVICES
ConslructionTem
{ix.StotionorY evoP.
ooler
Vent fon with
duct
Additionol both
Woter
Sewer
Air hondlsr over
FEEDERS
Sewer
CFM
DA'
'|
ONtYOFFICEFOR
Air hondler to
Bosis for Builder's Boord exemption:
NAME (Pleose Print)
TURE
TSSUANCE OF PERI\II
TOTAT CHARCES
x
x
x
TOTAT YATUATION
tlood Ploin
Const.
rts.Moin
Fire GrouP
Lood ttg. Access
- Sq' ftg' Other
Zone
s DeveloPment
Plon Ck. Res
Per
Plon Ck. Comm/ lnd
PerBUITDING PERMIT
Chorges ond
Surchorges
Totol Comb.
Demo
Pt UtttBtNC Penlr tt
Chorger ond
Surchorges
Sidewolk
c
PERMIT
Chorges ond
Surchorger
Curb Cut IOTAT[icxrNtcll Prnmr
Chorges ond
Surchorges
---=---------
Owner
./.
€t
-lr
or
coMBINATION APPUCATTON/pERw,.,cAp)
l. Applicont to furnish
A. Job Address
B. Legol Descriptionl. exqmple-tox lot 100, Lone County Mop Reference I7 03 432. exomple-Lor l. Block 3,2nd Addition ro Springfield Esto?esC. Nome, etc. of owner ond construclion lenderD. Energy SourcesI. exomple-heot,/electricol ceilinq,/or forced oir gos2. eE rnplE-wore rlEG7Eleilrico I z oi soto rE. Squore fooroge or roluotioilil]-l. exomple-.l,2Ig rq.foot house, 500 sq. foot goroge2. exqmple-if new proiect, checki-ew_ii oddiri-on, c-heckodd, etc.
F. Building permit informotion:l. exomple-conslruct single fomily house with qn oilochedgoroge
G.
H.
3
=gels-remodel
exisring goroge inro fomily roomJ. exompte-convert single fomily residence intorelTEuidnt (chonge o1 use)
Volue of work os defined in Section 303 (o) of theStructurol Speciolty Code
-DESIGN TEAM AND CONTRACTORS
To ovoid design or construction deloys, Building DivisionStoff must be oble to <
d e ; i s ; #o; ; ; ;;;' ;,'i'J:i'.T? ::$:T; : i'j' " "' re s o r d i n s
ll. Abbrevioted prumbing, Mechonicor & Erectricor saheduresA. Except where blonk spoces occur in the description portionof the Mechonicol ond rr"irri."f 's.i"d;l.,;rd.;;;ffi;;
need fill-in only rhe No. Ao*e. ;diocent to the opproprioteitem(s) ro be instolled -- --I-
B. Full Plumbing, Mechonicol, ond Electricol Schedulesore ovoiloble or rhe Building DivisionI. To conserve spoce on thJpermitiorm the schedureshove been obbrevioted2' rf rhe item(s) to be instored ore not covered on the obbrevi-ored sc,hedules you should .oirrfr the fril-r"iJ;i;r--,c. BU|LD|NG DtvlstoN STAFF WtLr rrit our AtL FEES ANDCHARGES ON THE SCHEDULES-- ''-'
lll. Applicont to sign ond dote
Whenever possible, the initio.l .opplicotion will be used os oworksheer onry. Where p".riul.f Eririin"g oiuirion Sroff wirlprepore o typewriren copy ond return lito the .p;i;;J;;the rime rhe ocruol permir;r;rr;; ;;; his signorure.
lV. Fees ond Chorges
Plon check fees ore due ond poyoble ot the time of the oppticotion,ond no plons will be processed Lntillhese fees ore poid. Allother fees ond cho
is issued. rges ore due ond poyoble *t"n if," f"r.it
V. FOR OFFICE USE ONLY
- PERMIT VATIDATION
Permit Clerk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Additionol proiect lnformotion:
nome signolure
PLANS REVIEWED BY: