09-104428o ��
GENERAL
MECHANICAL FIXTURES
Value of Mechanical Work $
(A COPY OF BID OR ESTIMATE MUST BE PROVIDED)
Indicate number of each type of fixture to be installed or relocated as part of tits project. Do not include existing fixtures to remain.
AIR HANDLING UNITS
FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER
FIREPLACE INSERTS HOODS (c..mr-iai)
BOILERS
FURNACES HOT WATER TANKS (Gas)
COMPRESSORS
GAS LOG SETS REFRIGERATION SYST
DUCTING
GAS PIPING WOODSTOVES
GENERAL
PLUMBING
FIXTURES
Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS (or Tbb/Shower Combo)
LAVS (Hand Stk.)
TOILETS WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (Futchrr,/utility)
WATER HEATERS
HOSE BIBBS
SUMPS
WASHING MACHINES TOTAL FIXTURES
GENERAL
INFORMATION
PROJECT VAWATION
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
$ - 1Z I UV() -OV
Additional Information
NEW BUILDING
$
EXISTING /PREVIOUS USE
LOT SUE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
ADDITION
❑ Yes X No
❑ Yes No
RESIDENTIAL
AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
............ ........ .. .......... ... ..................................... . ............................................................. ..
BASEMENT
............. I ...... ........... ............... I .......... I .............. 1. .... .......... ..................................... .... .................... ...
FIRST FLOOR (or Mobile Horne)
.......... .................. ............. . . . . . ...... ..... -- ..............
SECOND FLOOR
.......... 1. ........... .... ................. . ....................... ............ ................................. ................
COVERED ENTRY
........... .... I ............ .................... ... ............... .................................................................... .............. .................
DECK
....... ....................... ......... ...... I .......... ............. .............. .................... .......................
GARAGE ❑ CARPORT ❑
.... .............. I ........... ......... ... .......... ......................... .... ....... .................. .........
OTHER (describe)
.......... ..., ........... ... ...... .... ........... .......... .. .............................. I ..............................
XUarm PROPOSM TOTAL
Area Totals
**NW HOMER ONLY"
ESTIMATED SELLING PRICE #OF BEDROOMS
COMMERCIAL
- NEW /ADDITION
AREA DESCRIPTION
Area
In Square Feet
Occupancy Group(s)
Construction
Type
# of
Stories
Additional Information
NEW BUILDING
ADDITION
COMMERCIAL - REMODEUTENANT IMPROVEMENTS
AREA DESCRIPTION
Area
In Square Feet
Occupancy Group(s)
Construction
# of
Stories
Additional Information
TOTAL BUnDING
1, 9 b
VS
I
TENANT AREA ONLY
ftoizar AREA ONLY
I
f
Bulletin #100 - 4/21/2009 Page 2 of 4 k:\Handouts\Permit Application