HomeMy WebLinkAbout9512-04City of Port Town
~P~~-r: ~ pWNER ~ CONTRACTOR ~ oTHER: p
PERMIT # 1 S (Z -O
COMMENTS:
Z3 ( rl a ~ ~egal Description: f~SiINGS 2.iD Addition
SITE ADDRESS: ~i ~~ Bloc'n(s) b' Lot(s) Zone: ~~
r ~" I 1 (G ~~ ADDRESS: I ~ ~ I - (
OWiYER: Z '
CONTRACTOR: r PA'~/i- ADDRESS: J v
CONTRACTOR LICENSE ~ EXPIRATION DATE:
OWNER PHONE ~ ~ ~ ~~~ 3 ZZ CONTRACTOR PHONE ~' ~~ She 6
NE3. TYPE OF E 7IPMENT ( FEE ?NO, TYPE OF:FIXT'€3RE' '` F~=
I RANGE WATER CLOSET
;';GOD:?"c.Li.ETSTC`.'E ~ I BATHTUB
GAS FURNACE bra is 13. ZS I LAVATORY !
l.Oti~V CtCSIVIV BURIMER orv ~ ~ i SHOWER i
U'v i T HEATER beu ;: II8'z9 KITCHEN SINK
BOILER bra's: I DISHWASHER
' GAS PIPING I ~ I LAUNDRYTRAY
~ EV,APORATION COOLERS bra's: ~ ;CLOTHES WASHER
AC UNiT bra's: I I WATER HEATER
HEAT PUMP bra;: roar: I URINAL
REHEAT BOX bra is f I, DRINKING FOUNTAIN !
AIR HANDLING UiYIT bra is I I FLOOR SINK OR DRAIN
j EXi-IAUS T rAI~IS I ,SLOP SINK ~
I RANGE HOOD (:aidenaal? I ~ I WATER PIPIING & ALTERATION
I RANGE HOOD !comm I GREASE TRAP/INTERCEPTOR (
I CLOTHES DRYER I HOSE BIBBS
'INCINERATOR ~ LAWN SPRINKLER SYSTEM
DUCT ALTERATION SWIMMING POOL
BLDG. SEWER (mobilc /moved house)
T.AI`iKS e:
REFRIGERATION UNIT I ROOF DRAINS
OTHER OTHER:
I MECHANICAL PERMIT FEE ~ ~~ PLUMBING PERMIT FEE .;_> _
- - - - --
(2008) Mechanical Fees 35 ~ Z S Plumbing Fees
State Fee `i ~ so State Fee
(z 00 5) ~ , - TOTAL
TOTAL
~PLICANT'S SIGNATURE:
$ 3~. ~S
Balauce Due Fees Received by Deputy-Clerk Date Reed
. _ __ __.. (2009 )
(2005
Receipt No.