2014, 05-23 Permit App: BLD-2014-1175 Plumbing FixturesCommunity Development
Permit Center
11703 E S
FAX: ):
Ave, Suite B-3
9206
20-5240
Plumbing Permit Application
Commercial Residential
Project rr
Uty
RECEIVED
MAY
SITE ADDRESS: ""//a- N . . 7-? 4 ,t7C,J
CSV PERMIT CENTER
Building Owner
Name: g- a >%% (/SLoe h twi('
Address: 'ii ti E CPM-) U ST . 'l y g
Contractor
Name: �►~' / /%/4jfS
Address: /2-a' nJ t C 4 r
License No: / 1144, 881 Pt,
Contact/Project Manager:
ame: T,Ylt-77`^ `�)1- / frirekt t
Phone 611 69
AU #�_
Fax:
City: SPO v4.44 -el
Phone: $c8i^ x(40 S
City: Sy0 !/f9 -L,
City Business Lic:
Phone: 86 6—y7,0,
tV.
State: WV—
Zip: 7(1.2_0 (e
Fax:
Stare: 0,1—
Zip: ''9� 6
Signature
CURRENT FEES AVAILABLE AT: r ,
under the quick links for Forms, Master Fee Schedule.
# UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
2. -
URINALS URINALS
TUBS
I
SHOWERS (per trap)
SINKSPrep/Culinary
Lav/Basins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food,
Meat
DISHWASHER
I
CLOTHES WASHER
f
GARBAGE DISPOSAL
WATER SOFTNER
FLOOR DRAIN
Area, Case, Coil, Trench, Condensate
ROOF DRAIN/OVERFLOW DRAINS
FOUNTAIN, DRINKING
WATER PIPING/DRAIN-IN WASTE
Installation, Alterations, Repair, Reversals
I
WATER USING DEVICE
Ice and/or Coffee maker, hose bib, steamer proofer, carbonator, swamp cooler
3
PRIVATE SEWAGE DISPOSAL SYSTEM
WATER HEATER
If Gas, See Mechanical
INDUSTRIAL WASTE PRETREATEMENT
INCEPTORS
Including traps, vents except kitchen type grease interceptors functioning as fixture
traps
REPAIR OR ALTERATION
Water piping, drainage or vent piping
ATMOSPHERIC TYPE VACUUM
BREAKER
BACK FLOW PROTECTIVE DEVICE
Ctherthan atmospheric type vacuum breakers
MEDICAL GAS
INCEPTORS
Signature
CURRENT FEES AVAILABLE AT: r ,
under the quick links for Forms, Master Fee Schedule.