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HomeMy WebLinkAboutFLINT ST 1315_00-00001125 City of Lake Elsinore 130 South Main Street PERIVHT PERMIT NO: 00-00001125 DATE : 11/16/00 JOB ADDRESS . . . . . 1315 FLINT ST TENANT NBR, NAME STULL INDUSTRIES DESCRIPTION OF 6dORK PLUMBING PERMIT OWNER CONTRACTOR WSS INVESTMENTS LLC OWNER 1315 WEST FLINT LAKE ELSINORE CA 92530 A. P. # . . . . . - - SQUARE FOOTAGE 0 OCCUPANCY . . . GARAGE SQ FT 0 CONSTRUCTION . . FIRE SPRNKLR VALUATION . . . ZONE . . . . . . UN ELECTRICAL PERMIT QTY UNIT CHG ITEM CHARGE BASE FEE 30 . 00 2 . 00 X 1 . 0000 SWITCHES / 1ST 20 2 . 00 4 . 00 X 1 . 0000 RECPT,OUTLET / 1ST 20 4 . 00 2 . 00 X 1 . 0000 LIGHTING FIXTURES/1ST 20 2 . 00 1 . 00 X 16 . 2500 MISC. WHERE NO OTHER FEE 16 . 25 1 . 00 X 5 . 0000 PROFESSIONAL DEV FEE 5 . 00 PLUM BING PERMITS QTY UNIT CHG ITEM CHARGE BASE FEE 30 . 00 1 . 00 X 5 . 0000 PROFESSIONAL DEV FEE 5 . 00 10 . 00 X 8 . 7500 FIXTURE OR TRAP 87 . 50 FEE SUMMARY CHARGES PAID DUE PERMIT FEES ELECTRICAL PERMIT 59 . 25 . 00 59 . 25 PLUMBING PERMITS 122 . 50 . 00 122 . 50 TOTAL 181 . 75 . 00 181 . 75 SPECIAL NOTES & CONTDITIONS PLUMBING AND ELECTRICAL FOR BATHROOM AT STULL INDUSTRIES 2000 1125 --+Hh-.-75-BP Date: 11/16/00 16 Receipt: 0002729 DECK 643 00000000000000 City of Lake Elsinore ' Please Read and Initial: Building Safety Division 1. 1 am Ucensed under the provisions of Business and Professional Code Section 7000 et seq.and my license is in full force. Post 1n OUnsp1uxxiS place 2. 1,as owner of the property,or my employees w/wages as their sole .� �7 compensation will do the work and the structure is not intended or on the cb offered for sale. J 3. 1,as owner of the property,am exclusively contracting with licensed You must furnish PERMIT NUMBER contractors to construct the project. and the JOB ADDRESS for each _ 4. 1 have a certificate of consent to set fin sure or a certiflca te ofWorkers respective Inspection: Compensation insurance or a certified copy thereof Approved plans must be on job 'P6• 5. 1 shall not employ any person to any manner so as to become subject at all times: to Workers Coompensation laws in the performance of the work for which this permit is issued. Note lfyou should become subject to Workers Compensation after making this certification,you must forthwith comply with such pro- visions or this permit shall be deemed revoked. Code Approvals Date Inspector ��77 �^ }/ EL01 TempElec Services '^G 0 . S(� cs))--1 hJC� PL01 Soil Pipe Underground ))'� LX---S S" /QLL C_ EL02 Elec Conduit Underground BP01 Footings BP02 Steel Reinforcement // BP03 Grout 'Z✓ '"� lam! l 1, 1-r-(- � j A G BP04 Slab Grade l- PLOt Underground Water Pipe SS01 Rough Septic System SW01 On Site Sewer RP05 Floor Joists Electric-Conduit EL04 Rough Electric-Wirirm EL05 Rough Electric-T-Bar ME01 Rough Mechanical ME02 Ducts,Ventilating PL04 Rough Gas Pipe-Test PI 02 Root Drains BP10 Framing I hin BP12 Insulation Ho O S a �- BP13 Drywall Nailing -Wo 0 V Ly BPI t Lathing&Siding PL99 Final Plumbin EL;19 Final Electrical ME99 Final Mechanical BP99 Final Building Code Pool&Spa Approvals Date Inspector OTHER DEPARTMENT RELEASES Dep.Inspector Department Approval required prior to the Pool Pool Steel Rein./Forms building being released by the City P001 Pool Plumbin Press.Test P003 Pre-Gunite Date Ins EL06 Rough Pool Electric Inspector Planning Sub List Approval Landscape P004 Pool Fencing/Access Finance P005 Pre-Plaster Engineering P009 Final PooVSpa City of Lake Elsinore 130 South Main Street APPLICATION NO. APPLICATION FOR p© 2iE;' ELECTRICAL APPLICATION RECEIVED PLUMBING PERMIT DATE MECHANICAL AP By p Tom- I certify:hot I hove read this application and state that the BUILDING ADDRESS above information is correct. I agree to comply with all city ' r �� and county ordinances and state laws reloling to building TP-ACT BLOCK PAGE LOTrPARCEL construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspec- N*A E tion pur o es. a /4✓CS77111 fi/K 7 5 L L C r .Z !:.AI11.NG PH ADDRESS , illu - 0 CITY STATE ZIP l�4KF L 1-5 ORr C/`} 9o2S3d Signature of AID a .or Agent Date 1 hereby offirm that I am licensed under proms ,ons of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect AGENT FOR CONTRACTOR OWNER = I.IC EN SE• CITY BUSINESS Z ANDCLASS TAXI O rta tF AGENT'S NAME JX5/V"✓1 S G�=�2y�f v a 6 F.rs ,2^4'Y e` �2 4AI11NG ^d �O x ,�� ^ ADOPESS AGENT'S ADDRESS�J / CITY STATE 21P PHONE !JLREET CITY STATE ZIP �y` jji4_ BUILDING PERMIT NO. 9.?S S/ 9 COt:i.a.ACTOR5SIGNATURE DATE ELECTRICAL Quon PLUMBING Quon MECHANICAL Quart New Residential Multi Family Fixture or Trap O Furnace up to 100,000 BTU's New Residential Single Family Building Sewer Furnace Over 100,000 BTU's Private Swimming Pools Rain Water Sys per Drain Floor Furnace/Vent Switches Ist 20 2 Private Septic System Unit Heater/Wall Heater Switches/Over 20 Water Heater. Vent Install/Relocate/Replace Vent Recpt.Outlet 1st 20 Gas Piping System 1-4 Outlets Ventilating Fan Recpf.Outlet Over 20 Gas Piping S or More Outlets Exhaust Hood Lighting Fixtures Ist 20 Dishwasher Fireplace Res.Fixed Appliance Outlet Solar Tank Commercial Incinerator Non-Res-Appliance Outlet Solar Collector per Panel Air Handler► 10,000 CFM 100-200 Amp Service a 600V Grease Trap (interceptor) Air Handler -4 10.000CFM 200-1000Amp Service-4 600V Install.Alter or Repair System Fire Dampers Service Over 1000 Amp or 600V lawn Sprinkler System Registers Misc Apparatus.Conduits.ETC Backflow,Device Smaller than 2" Boiler/Compressor to 3 H.P. Signs Backflow Device Larger than 2•' Boiler/Compressor 3.15 H.P. Sign Branch Circuit Floor Drain ' Boiler/Compressor 15-30 H.P. Busways. EA 100 it Floor Sink Boiler/Compressor 30-50 H.P. Temporary Power Service Water Service Boiler/Compressor► 50 H.P. Temp.Power Distribution Sys. Alter or Repair Drain or Vent Repair/Alter Misc.HVAC Equip. MOTORS,TRANSFORMERS Fire Sprinklers per Building Motors up to 1 H.P. SWIMMING POOL Motors Tronsformersl-10H.P. Swimming Pool Public Motors Transformers 10.50 H.P. Swimming Pool Private Motors. Tronsformers 50.100 H.P. %Voter Heater Vent Motors Transformers► 100 H.P. Replace Piping Replace Filter Misc.Replace Gas Piping REV DATE I 1-90 :d- City of Lake Elsinore 130 South Main Street APPLICATION FOR APPLICATION NO. BUILDING PERMIT f� -5; b 3�71vI<) Ol // APPLICATION 17 RECEIVED/ TDATE -� VALUATION CALCULATIONS AP; By 1 st FLOOR SF BuaDINc ADDRESSZOOK El ,1 G�1 ��,f �C g•�_ 2nd FLOOR SF TRACT BLOCK PAGE�/ Jl LOT/PARCEL 3rd FLOOR SF GARAGE SF � �o F, bee pass STORAGE SF i MAILING PHONE DECK&BALCONIES SF p ADDRESS 111 (� ; �4r CITY STATE ZIP _ OTHER: O es � C 4, SF I hereby affirm that I am licensed under provtsrons of Chapter 9(commencing with Section GRADING CUT CY of D+aision of the Business and Professions Code and my license is in full force and a ^ ar+ ilxt. a AUCENNDCF= ��' CITY BUSINESS FILL CY AND CLASS g 1Axr VALUATION: 0 NA�� FEES Ao a s �ALv� C�f��q69'4I61 BUILDING PERMIT $ arY SI TE ZIP PHONE 3 CONTRACTOR's SIGNATURE DATE PLAN CHECK ' �! ADDITIONAL PLAN CHECK NAJW LICENSE. 0 Z MARING GRADING PLAN CHECK U AOIIREss < CITY STATE ZIP PHONE ;-,NEW ',]REPAIR OCC GRP./ CONST. DIVISION: TYPE: MICROFILM ADDITION `MOVE NUMBER OF NUMBER OF LTERATION DEMOLISH STORIES: BEDROOMS: COPIES OTHER ZONE: --SINGLE FAMILY units HAZARD AREA? YES NO IMPRO FEES Q" SCHOOL FEES 0 units _'CONDOMINIUMS units SPRINKLERS REQUIRED? YES NO _TOWNHOMES units PROPOSED USE OF BUILDING: -COMMERCIAL ; .INDUSTRIAL PRESENT fTOF UILDING: PAID DATE JOB DESCRIPTION 0 1 certify that 1 have read this application and state that The V above information is correct. I agree to comply with all city S and county ordinances and state laws relating to building construction. and hereby authorize representatives of this city to enter upon the above-mentioned property for inspec- tion purposes. -/© ��� Signaturif of Applicant or Agent Dote 000000M 000M370 $206.b3 BP AGENT FOR CONTRACTOR C OWNER HECK . AGENT'S NAME AGENT'S ADDRESS STREET CITY STATE ZIP REV DATE 11-1 90 _= Cityof Lake Elsinore 130 South Main Street APPLICATION NO. APPLICATION FOR ELECTRICAL APPLICATI N RECEIVED PLUMBING PERMIT DATE MECHANICAL [AP` 77 / ^ ^ / By : I certify that I have read this application and state that the utLDiNG ADDRESS _ L above information is correct. I agree to comply with oil city �! 1 and county ordinances and stale laws relating to building iP.ACT BLOCK PAGE LOT/PARCEL construction, and hereby authorize representatives of this city to enter upon the above-mentioned property for inspec- tion purposes. rt=L vC Z MAILING PHONE ADaRESS CIfY STATE rZIP A�oo�� o,2es , C� Signature of Applicant Ir Agent Date I aH hereby +rm+hot I am licensed under provisions of Chapter 9(commencing with Section A)CO)of Dr:iston 3 of the Business and Professions Code.and my license is in full force and effect AGENT FOR CONTRACTOR - OWNER MENSE, 6 V� CITY BUSINESS Z "D CL Ass TAX r 0 NAME AGENT'S NAME L �!!/� �S ADDRESS AGENT'S ADDRESS v v v STREET CITY STATE ZIP cttr 1V�« Cis SATE ZIP PHONE C CiOR�S SIG.ATURE DATE BUILDING PERMIT NO. � �' �� •�� ELECTRICAL Quart PLUMBING Quart MECHANICAL Quart New Residential Multi Family Fixture or Trap Furnace up to 100,000 BTU's New Residential Single Family Building Sewer Furnace Over 100,000 BTU's Private Swimming Pools Rain Water Sys per Drain Floor Furnace/Vent Switches/ 1st 20 D Private Septic System Unit Heater/Wall Heater Switches/Over 20 Water Heater Vent Install/Relocate/Replace Vent Recpt.Outlet/ 1st 20 Gas Piping System 1.4 Outlets Ventilating Fan Recpt.Outlet/Over 20 Gas Piping 5 or More Outlets Exhaust Hood Lighting Fixtures ' 1st 20 Dishwosher fireplace Res.Fixed Appliance. Outlet Solar Tank Commercial Incinerator Non-Res.Appliance 'Outlet Solar Collector per Panel Air Handler► )0,000 CFM 100-200 Amp Service -4 600V Grease Trap (Interceptor) Air Handler-4 10,000CFM 200-1000 Amp Service -4 600V Install,Alter or Repair System Fire Dampers Service Over 1000 Amp or 6001V Lawn Sprinkler System Registers Misc Apparatus,Conduits.ETC Backflow Device Smaller than 2" Boiler/Compressor to 3 H.P. Signs Bockflov Device Larger than 2" � Boiler/Compressor 3-15 H.P. Sign Branch Circuit Floor Drain Boiler/Compressor 15-30 H.P. Buswoys/EA 10011 Floor Sink Boiler/Compressor 30.50 H.P. Temporary Power Service Water Service Boiler/Compressor► 50 H.P. Temp.Power Distribution Sys. Alter or Repair Drain or Vent Repair I Alter Misc.HVAC Equip. MOTORS:TRANSFORMERS Fire Sprinklers per Building Motors up to 1 H.P. SWIMMING POOL Motors/Transformers 1-10H.P. Swimming Pool Public Motors/Transformers 10-50 N.P. Swimming Pool Private Motors/Transformers 50-100 H.P. Water Heater Vent Motors/Transformers► 100 H.P. Replace Piping Replace Filter Misc.Replace Gas Piping 7—1 —i 99S 9:0 1 Pt•) F FP014 PPP F!ESE Rtia_=SS 1 -? S782S9d P. 1 SOUTH COAST AIR OUALI TY MANAGEMENT DISTRICT Pcrmit No. _ 21865 East Copley Drive, Diamond Bar, CA 91765 D98380 A/N 310590 PERIN41T TO CONSTRUCT/OPERATE This initial pcm-it-must-be-mnewed A:NNUAL.LY unless the equipment-is•moved,-or chaiiges owntrship:- If the billing for annual renewal fee(Rule 301.0 is not received by the expiration datc,'contaet the District. Legal C-Mner ID 107074 or Operator: PRO FIBERCLASS,TONY & CYN rBIA ORTEGA DBA 32i8l CRESCENT AVE LAKE ELSINORE, CA 92-530 I Equipment Location: LU3\\ FLINT ST STE E.LAKE ELSINORE, CA R230 Equipment Description: SPRAY BOOTH, BLEEKE.R BROS., FLOOR TYPE.-MODEL NO.F-10-7-7, 10--0- NN, X 10--0- L. X 7-0" H.,WITH O\-E 3 HP ENiAUST FAN AND T\\T\7Y 20-X 20-EXHAUST FILTERS. Conditions: 1. OPERATION UP THIS EOULPMENT SHALL BE CONDUCTED IN ACCORDANCE\VITH ALL DATA AND SPECIFICATIONS SUt3\DTTI D WITH THE APPLICATION UNTDER WHTCH THIS PERMIT IS ISSUED ViNLESS OTHERWISE NOTED BELOW. 2- THIS EOUIP,NE\T SHALL BE PROPERLY Al AINTAINED AND KEPT IN GOOD OPERATING CONDITION AT ALL T11ME.S. 3. A GAUGE SHALL BE ENTSTALLED A.ND N AMAI`'ED TO INDICATE, IN INCHES OF WATER,THE STATIC PRESSURE DLFFE.RENTLAL ACROSS THE EXHAUST FILTERS. IN OPERATION,Tf m PRESSURE DIFFERENTIAL SHALL NOT EXCEED 0 25 LNCHE.S OF WATER. 4. THIS SPRAY BOOTH SHALL NOT BE OPERATED UNLESS ALL EXHAUST AIR PASSES THROUGH FILTER IMEDLA AT LEAST 2I`C:HES THICK. 5. THIS EQUIPNIENT SHALL BE OPERATED IN COMPLIANCE WITH RULES 1162 AND 1171. 6. THE TOTAL QUAi\TJTY OF VOLATILE ORGANNIC COMPOUND (VOQ EIVUSS1ONS DISCHARGED FROM THIS FACILITY SHALL NOT EXCEED 60 POUNDS IN ANY ONE DAY, i 7. IN ADDITION TO RECORD KEEPING REQUIREAIEIS'TS IN RULE 109,THE OPERATOR SHALL KEEP ADEQUATE RECORDS FOR THIS FACILITY TO VERJFY DAILY VOLATILE ORGANIC COI`IPOUND (VOC)EMISSIONS 1N POL�IDS AND THE VOC CONTENT OF EACH MATERIAL AS APPLIED (INCLUD1vG WATER AND EXE:NIPT COIWOUNDS). THE\'OC.EMTSSJON FACTOR TO USE FOR POLYESTER RESINS WITH SUPPRESSANT IS 0.05 POUND VOC PER POUND OF RESIN. ALL RECORDS SHALL BE PREPARED I\.A FORMAT WHICH IS ACCEPTABLE TO THE DISTRICT, SHALL BE RETAINED ON THE PREMISES FOR AT LEAST TWO YEARS, AND SHALL ORIGINAL i APPRC`•lAL RNERSIC rC)UN Y FIRE DEPT. Bye__ �rt TITLE r _ I DATE �i '4-94 CAS i - 1 THE F'- - --MENT APPROVAL ARE GOOD FOR � 3 EXCEED ONE YC.:. i - . " : L;A�E SPECIFIED E C. "L DATE' UNE. i� r L ; ,A Xl ,�► �Nof 6- 7 `to he t,u cpwk, t��ol �>ANF-1 S, i M f10AtD ON NC.1000N C AAJt1RMT• - City of Lake Elsinore 130 South Main Street APPLICATION FOR APPLICATION NO. BUILDING PERMIT 4 5 - // �S_ APPLICATION RECEIVED DATE /,;?- - 3 - / 5— VALUATION CALCULATIONS AP#? --6-a-3— I By ` I st FLOOR SF BURIxNG✓ADDREss 5 F I f J J 2nd FLOOR SF TRACT BIOCK PAGE/V LOT'PARCEL 3rd FLOOR SF GARAGE SF NAMLE a STORAGE SF z MAILING _ / n A PH O ADDRESS // ' / // / ��y//,/ DECK&BALCONIES SF ✓ ���------111 CCC�YYYY , ,` V OTHER: CITY I— STATE",ZI Z;l TAT .ZlZ;lj 3c-) SF I hereby affirm that 1 am licensed under provisions of Chapter 9(commencing with Section 7=f of Division 9 of the Business and Professions Code.and my license is in full force GRADING CUT CY a deffuci FILL CY rrsE. CITY BUSINESS t AN TAX. VALUATION: $ NAME FEES _ MA,LLNG \ ADDRESS BUILDING PERMIT $ - CITY STATE z PHONE L / CCWTRACTOR'S SIGNATURE PLAN CHECK ADDITIONAL PLAN CHECK "AAA "BEN u Z MARING GRADING PLAN CHECK AtH1RESS < CITY STATE/ZIP PHONE 2NEW L:REPAIR OCC GRP./ CONST. DIVISION: TYPE: MICROFILM ADDITION --MOVE NUMBER OF NUMBER OF ALTERATION " DEMOLISH STORIES: BEDROOMS: COPIES OTHER ZONE: SINGLE FAMILY units HAZARD AREA? YES NO IMPRO FEES E: SCHOOL FEES 0 APARTa'tENTS units CONDOMINIUMS units SPRINKLERS REQUIRED? YES NO -:TOWNHOMES units PROPOSED USE OF BUILDING: .COhAMERCtAL i_INDUSTRIAL PAID PRESENT USE OF BUILDING: DATE JOB DESCRIPTION © 1 certify that I hove read this application and state that the above information is correct.1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above-mentioned property for ins Lion purposes. C� Signature pplicant or Agent Date 000000095 000001185 $44.06 BP Date: 12/06/95 06 Rc t: OOD2602 AGENT FOR CONTRACTOR E: OWNER 00000000000000 AGENT'S NAME AGENT'S ADDRESS STREET CITY STATE ZIP REV.DATE 11 1-90 City of Lake Elsin e 130 South Main Street APPLICATION NO. APPLICATION FOR APPLICATION RECEIVED ELECTRICAL PERMIT ERMIT DATE MECHANICAL AP- By I certify that I have read this application and state that the BUILDING ADDRESSTT Gj above information is correct. I agree to comply with all city / C�/ J`� and county Ordinances and state laws relating to building TRACT BLOCK PAGE LOTrPARCEI construction and hereby authorize representatives of this ily to enter upo tithe obove-mentioned property for inspec- t'a+'•E < C- I npurposes li✓�J L/ /di-5 �7""='`-� G-G L A:41tlT.'G PH 3 ADDRESS/ 0 CITY STATE,ZIP 3 v ignalure of Apph r gent alQ 1 hereby affirm that 1 am licensed under provisions of Chapter 9(commencing with Section 70M)of Dwtsron 3 of the Business and Professions Code,and my license is in full force and effect AGENT FOR CONTRACTOR OWNER LICENSE- CIT USINESS Z ANDCIASS T J15u 0 n f AGENT'S NAME .1INC, ADDRESS AGENT'S ADDRESS STREET CITY STATE ZIP CITY PHONE CON'RACTORS SIGNATURE DATE BUILDING PERMIT NO. ELECTRICAL Quan PLUMBING Quon MECHANICAL Quon New Residential Multi Family Fixture or Trap Furnace up to 100,000 BTU's New Residential Single Family Building Sewer Furnace Over 100,000 BTU's Private Swimming Pools Rain Water Sys per Drain Floor F6nace/Vent Switches ' Is'20 Private Septic System Unit Heater/Wall Heater Switches Over 20 Water Heater Vent Install/Relocate/Replace Vent Recpt.Outlet 1st 20 Gas Piping System 1.4 Outlets Ventilating Fan Recpt.Outlet Over 20 Gas Piping 5 or More Outlets Exhoust Hood Lighting Fixtures 1st 20 Dishwasher Fireplace Res.Fixed Appliance Outlet Solar Tank Commercial Incinerator Non-Res.Appliance Outlet Solar Collector per Panel Air Handler No, 10.000 CFM 100.200 Amp Service 14 600V Grease Trap (Interceptor) Air Handler 4 10,000CFM 200.1000Amp Service-4 600V 4— Install.Alter or Repair System Fire Dampers Service Over 1000 Amp or 600V town Sprinkler System Registers Misc Apparatus.Conduits.ETC Backflow Device Smaller than 2" Boiler/Compressor to 3 H.P. Signs Backflow,Device Larger than 2" Boiler/Compressor 3-15 H.P. Sign Branch Circuit Floor Drain Boiler/Compressor 15-30 H.P. Busways EA 100 it Floor Sink Boiler/Compressor 30-50 H.P. Temporary Power Service %Voter Service Boiler/Compressor► 50 H.P. Temp.Power Distribution Sys. Alter or Repair Drain or Vent Repair/Alter Misc.HVAC Equip. MOTORS -TRANSFORMERS Fire Sprinklers per Building Motors up to 1 H.P. SWIMMING POOL Motors Transformersl-10H.P. Swimming Pool Public Motors Transformers 10-50 N.P. Swimming Pool Private Motors Transformers 50-100 H.P. \Voter Heater Vent Motors Transformers► 100 H.P. Replace Piping Replace Filter Misc.Replace Gas Piping REV DATE 11-1-90 r City of Lake Elsin0 130 South Main Street APPIICATIO O. APPLICATION FOR 0— ELECTIUCAL APPLICATIO CEIV PLUMBING PERMIT DATE MECHANICAL APB By I certify that I hove read this application and state that the BUILDING ADDRESSr- 7- above information is correct. I agree to comply with all city and county ordinances and state laws relating to building TRACT BLOCK/PAGE LOT/PARCEL construction, and hereby authorize representatives of this city to enter upon the above-mentioned property for inspec- _ NAME tion p oses. K L) Z a,AtLING /' PHONE il 3 ADD9 �� > O G CITY STATE/ZIP L/L tL 3- Signature of Applicant or Agent Dote I hereby affirm that f am licensed under provisions of Chapter 9(commencing with Section 1000)of Division 3 of the Business and Professions Code,and my license is in full force AGENT FOR CONTRACTOR OWNERor and affect 110ENSfr � y� CITY BUSINESS i D ctns1C/ `f 0 TAX AN o N AGENT'S NAME ,-/7#,, C1,1f17 uNG ,r T C� AJ2 AGENT'S ADDRESS f f/�L ���1� � � STREET CITY STATE ZIP CITY STATE/ZIP PHONE r COMP ORSSIGNATURE DATE BUILDING PERMIT NO. ELECTRICAL Quan PLUMBING Quart / MECHANICAL Quart New Residential Multi Family Fixture or Trap Furnace up to 100,000 BTU's New Residential Single Family Building Sewer Furnace Over I00,000 BTU's Private Swimming Pools Rain Water Sys per Drain Floor Furnace/Vent Switches!1 st 20 Private Septic System Unit Heater/Wall Heater Switches/Over 20 Water Heater/Vent Install/Relocate/Replace Vent Recpt.Outlet/Ist 20 Gas Piping System 1-e Outlets Ventilating Fan Recpt.Outlet r Over 20 Gas Piping 5 or More Outlets Exhaust Hood Lighting Fixtures; Ist 20 Dishwasher Fireplace Res.Fixed Appliance 'Outlet Solar Tank Commercial Incinerator Non-Res.Appliance ;Outlet Solar Collector per Panel Air Handler► 10,000 CFM 100.200 Amp Service-4 600V Grease Trap/(Interceptor) Air Handler-4 10,000CFM 200.1000 Amp Service 4 600V Install,Alter or Repair System Fire Dampers Service Over 1000 Amp or 600V Lawn Sprinkler System Registers Misc Apparatus.Conduits,ETC Bockflow Device Smaller than 2" Boiler/Compressor to 3 H.P. Signs Backflow Device Larger than 2" Boiler/Compressor 3-15 H.P. Sign Branch Circuit Floor Drain Boiler/Compressor 15.30 H.P. Busways/EA 100 it Floor Sink Boiler/Compressor 30-50 H.P. Temporary Power Service Water Service Boiler/Compressor► 50 H.P. Temp.Power Distribution Sys. Alter or Repair Drain or Vent Repair/Alter Misc.HVAC Equip. MOTORS/TRANSFORMERS Fire Sprinklers per Building Motors up to I H.P. SWIMMING POOL Motors/Transformers I.10 H.P. Swimming Pool 4 Public Motors/Transformers 10.50 H.P. Swimming Pool 'Private Motors/Transformers SO-100 H.P. Water Heater, Vent Motors/Transformers► 100 H.P. Replace Piping Replace Filter Misc.Replace Gas Piping REV.DATE 11.1 90