BPM1989Application Date:
"° 8
Up to 100, 000 ....... .........................$15.00
Permit Fee: $ °
Job Address
rl /
®
500,000 -1, 000 ,000 ...........................
$40.00
4
1
Owner
Mail Address
Zip
� Iho
1.
Contractor
Mail A dress
Zip
Phone
2.
3. Class of Work:
O COMMER AL SIDENTIAL 1 O Plew
O Addition
O Alteration O Repair
eplacement
Describe Work:
4.
V 7a
°
MECHANICAL PERMIT
FEE
Furnace
Completion Date:
Boiler Chart
BTU
Fee
Up to 100, 000 ....... .........................$15.00
100,000-500,000 ..............................
$30.00
500,000 -1, 000 ,000 ...........................
$40.00
1,000,000 -1, 750, 000 ........................$60.00
Over 1, 750, 000 ...... ........................$100.00
Notice
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 presume to give
authority to violate or cancel the provisions of any other
state or local law regulating construction or the
performance of construction.
Fumace/Heat Pump /Air Conditioner (Per Unit) °
Up to and including 100,000 BTU / 3Ton ... .........................$15.00
Furnace/Heat Pump /Air Conditioner (Per Unit)
Over 100,000 BTU / 3 Ton .................... .........................$25.00
Refrigeration Units /Coolers /Lines /Compressor — Commercial
(New or Replacement) (Per Unit)
...................... ............................... .........................$
Boiler (use BTU Chart to left) ....................
Appliance Vent / Fans ........................$10.00
Duct System ......... .........................$15.00
Gas /Air Outlets .................First 5 x $6.00
.........Additional x $1.00
Radiant Heat Systems /Gas /Water
Pining System ....... .........................$50.00
Modular Home ............................... $50.00
Sib fure of CoWactor or Authorized Agent
Permit Issuance Fee............ ....... $25.00
Total
Current License on File es O No O N/A
Comment: ! t I
4 1
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PEFM14
Approved By:
Rev. 2008 -10
-1��'-CITY OF BLAIR
LOCATION OF INSPECTION:
BUILDING INSPECTION REPORT
❑ WASHINGTON COUNTY ❑ OTHER
NAME OF OWNER
f
CONTRACTOR
DATE INSPECTION REQUESTED `2 TIME INSPECTION REQUESTED�0 PERMIT NOL-�i
TYPE OF INSPECTION REQUESTED: [:1 CONFERENCE
F STATUS CHECK
BUILDING: F
FOOTING ❑ DECK FOOTING ❑ FRAMING F DRYWALL ❑ FINAL F PARTIAL
PASSED
FAILED
COMMENTS:
UTILITIES: ❑
SEWER TAP F SEWER ❑ SEPTIC F WATER TAP ❑ REMOTE ❑ WATER SERVICE
PASSED
FAILED
[-]
PARTIAL
❑
❑
COMMENTS:
ELECTRICAL: ❑
ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE F] PRECONNECT
PASSED
FAILED
❑
PARTIAL
❑
❑
COMMENTS:
MECHANICAL: El
ROUGH -IN ❑ FURNACE ❑ RADIANT HEAT_ -El," NPARTIAL
PASSED
FAILED
COMMENTS:
A o tj
PLUMBING: ❑
GROUNDWORK F ROUGH -IN F FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
PASSED
FAILED
❑
PRESSURE TEST
❑
❑
COMMENTS:
❑ OCCUPANCY GRANTED F CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS
F
INSPECTOR DATE OF INSPECTION MADE: d TIME L) P ed)
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY
_t� INSPECTION
' ITY OF BLAIR ❑ WASHINGTON COUNTY ❑ OTHE
LOCATION OF INSPECTION ( U <
� r �
NAME OF OWNER % "s r' . ` = , j , ' CONTRACTO
p,
„` r I
DATE INSPECTION REQUESTED " ' TIME INSPECTION REQUESTED " PERMIT NO ft
TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE
❑ S CHECK
BUILDING: ❑
COMMENTS:
FOOTING ❑ DECKFOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL
PASSED
❑
FAILED
❑
UTILITIES: ❑
❑
COMMENTS:
SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
PARTIAL
PASSED
❑
FAILED
❑
ELECTRICAL: ❑
❑
COMMENTS:
ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT
PARTIAL
PASSED
❑
FAILED
❑
MECHANICAL: ❑
COMMENTS.
MEN ��
PLUMBING: ❑
❑
CO MMENTS:
ROUGH .., -� .,_A/C ❑ FURNACE ❑ RADIANT HEAT ❑°FINAL NZARTIAL
F-
GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
PRESSURE TEST
PASSED
PASSED
❑
FAILED
❑
FAILED
❑
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
NOTESIREMARKS
r- e - o F Fd�e oAc e,
INSPECTO _ I v i p 4 t/ DATE OF INSPECTION MADE: d E. t r
FAXED OPPDIBURT REA TO CONNECT SERVICE: ON BY