HomeMy WebLinkAbout1695 BASSWOOD AVE; ; 74-1880; PermitPLUMBING PERMIT APPLICATION
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I B Class of work: [7 NEW 0 ADDITION 0 ALTERATION 0 REPAIR
I 4
CLOTHES WASH E R
DATE WATER HEATER
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3 Describe work: rrbusgrr#pt
"4 NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
PERMIT FEES
No. Type of Fixture or Item I Fee
SPECIAL CONDITIONS: t I WATER CLOSET (TOILET1 I$ I
URINAL
DRINKING FOUNTAIN
I I BATHTUB Ill
FLOOR--SINK OR DRAIN
LAVATORY (WASH BASIN)
SHOWER
KITCHEN SINK & DISP.
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CESSPOOL
I I DISHWASHER
APPROVED FOR ISSUANCE BY I I LAUNDRY TRAY kPPLICATION ACCEPTED BY PLANS CHECKED BY
MENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT THE GRANTING OF A PERMIT DOES NOT
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PRESUME TO GIV'E AUTHORITY TO VIOLATE OR CANCEL THE
I I GAS SYSTEMS: NO. OUTLETS Ill
I 1 WATER PIPING & TREATING EQUIP. Ill
I 1 WASTE INTERCEPTOR Ill I 1 VACUUM BREAKERS Ill I 1 LAWN SPRINKLER SYSTEM Ill I SEWER J
SEPTIC TANK & PIT
ROOF DRAINS
..
.LI"
SIGNATURE OF CONTRACTOR OR AUTHORLIED AGENT lD4TEI
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE1
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
INSPECTOR