00020106 (PLBG)APPLICANT NAME (L, F, MI)
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CITYICOMMUN ITYISTATEIZIP
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JOB SITE ADDRESS/SPACE
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CITYICOMMUNITYISTATEIZIP
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COU �E B.I
COUNTER L.U.T.VY
TRACT LOT
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TRACT NAME
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OWNER NAME (L,F,MI)
PHONE p
NEWTON 'ELEANOR
CONTRACTOR -FIRM NAME
L'ICNC p
ADDRESS
CITYICOMMUNITYISTATE/ZI P
PHONE p
BLD PE
FINAL
ARCIENG FIRM NAME LICNC p
ADDRESS
CITYICO M M U N ITYISTATEIZI P
PLAN p
PLANS EXAMINER
APPROVE DATE
USE OF PERMIT
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SSB SSB
RSB
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APPL/PRMTp PSDATE_ 00 /\'
PLUMBING FFA; $6.50
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TOTAL .
FEE
$
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NC
COU �E B.I
COUNTER L.U.T.VY
P L U M 1s X N G P C R M I T
TOTAL PERMIT COT 19
PLUMBING FEE COMPUTATIONS Permit Fee (if aP lica le) FEE-. $4.00
OAS PIPING SYSTEM -9 to 5 OuTle�ts-0 b or P1ore audits l 0 FEC -i $2.50
r'
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs & Frms
34
Plenums & Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
36
Inlets & Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
39
Appl. Clearance
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L. ❑
43
Final
IDA
Fireplace T.O. ❑
No
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick
R
Value
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final
PLUMBING APPROVALS
15 Ground Plumb
16 Water Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service
24
25
Gas Test
Final
Tank Pit L.line
REAR OF PROPERTY LINE t
J'
PSL P/
ELECTRICAL APPROVALS
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding�Wire'"
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
' 'O6 MAE'VOLUMB Iiia CO
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CONTRACTOR -FIRM NAME
LICNC #
ADDRESS
CITVICOM MUN ITVISTATEIZIP
PHONE #. ]B
INSPECTOR
FINAL DATE
ARC/ENG FIRM NAME
LICNC #
ADDRESS
CITVICOMMUNITYISTATEIZIP
PLAN #PLANS EXAMINER
APPROVE DATE
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NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
I
Set Back
33
Ventilation System
2
Ftgs 8 Frms
34
Plenums 8 Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
36
Inlets 8 Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
39
Appl. Clearance
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L. E]
43
Final
10A
Fireplace T. 0. C]
No
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final
PLUMBING APPROVALS
15 Ground Plumb
16 Water Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test
25
Final
Tank Pit L.Line
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grouriilrng Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME