2014, 05-23 Permit App: BLD-2014-1172 Plumbing FixturesCommunity Development
Permit Center
11703 E S
Ave, Suite B-3
9206
20-5240
Plumbing Permit Application
Commercial Residential
Project !- & H 7
RECEIVED
MAY 232014
ERMIT FEE:
C.SV PP "[Viii CI -N I tR
SITE ADDRESS: � /J - j -,4't , OG le
SUB #[ 4 J REV. j
Building Owner
Name: - 77 'P (; vrV' f
9//‘
Address: r S>' a - r sr. Y V S
Contractor
Name: 7 4-((bILt r
Address: /2,5 N - 'CAA Sl'
License No: CQ�y 1,111 l S8% QG
Contact/Project tM''aahh//ager:
Name: 77/20.4 C04-1,7 m_
Phone: 53 -8 bg2.
City: SO (14'4—
Phone: $6'-Y9dc
City Ste) (Mu_ -
City Business Lic:
Phone:
66B-f%S
Fax:
State: rA✓N9` Zip: yZ 06
Fax:
State: W tp— Zip: ' 9.266
Signature
CURRENT FEES AVAILABLE AT:
under the quick links for Forms, Master Fee Schedule
# UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
2.
URINALS
TUBS
/
SHOWERS (per trap)
)
SINKS
Lay/Basins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food,
Prep/Culinary Meat
DISHWASHER
/
CLOTHES WASHER
GARBAGE DISPOSAL
WATER SOFTNER
FLOCK DRAIN
Area, Case, Coil, Trench, Condensate
ROOF DRAIN/OVERFLOW DRAINS
FOUNTAIN, DRINKING
WATER PIPING/DRAIN-IN WASTE
Installation, Alterations, Repair, Reversals
t
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
Other than atmospheric type vacuum breakers
MEDICAL GAS
INCEPTORS c----,.
Signature
CURRENT FEES AVAILABLE AT:
under the quick links for Forms, Master Fee Schedule