BPP21339
LOU
Application Date: rl ( 0 Permit Fee: $_ - W
Job Address 1 3 ® Pa „ f c S
Owner Mail Address Zip Phone
Contract Mail Addre Zip Phone
3. Class of Work: O COMMERCIAL RESID NTIAL New O Addition O Alteration O Repair O Replacement
Describe Work:
4. e
PLUMBING PERMIT FEES
Comments: Modular Home ......................$50.00
Type of Fixture No.
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.
or Authorized Agent
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS 1S Y0UR PERN111
Approved By:
L I
Kitchen .............................. $12.00 x
2__ M
Bath..... Residential /Single Stall $12.00 x �_
12.0o
...... ..............Multi -Stall $25.00 x
Rough -In Bath ........................ $8.00 x
Additional Sinks .....................$6.00 x
Slop Sink/Laundry Tray/Drain ..... $6.00 x �_
f a y C)
Water Heater .........................$10.00 x _—
0 • UC1
Outside Water Faucet ...................$6.00 x _
(P < Uo
Drinking Fountain ........................$6.00 x
Backflow /Grease Trap .............$15.00
Water Service .......................$15.00
Sewer .. ............................... $15.00
Groundwork .........................$15.00
Septic Tank & Laterals............ $15.00
Lawn Sprinkler System ............ $10.00
Sprinkler System (Commercial).. $3 0.00
Gas /Water Piping System
- TC6mmercial ) ........................$50.00
Permit Issuance Fee .................$25.00
Total 'I
Current License on File Yes O No O N/A
Comment:
VA
.ev. 2008 -10
A
1 ,CITY OF BLAIR
LOCATION OF INSPECTION:
❑ WASHINGTON COUNTY
❑ OTHE
P
jr
NAME OF
r�
r CONT12 ACT(1R• !F$�1 ✓, �. A.,
DATE INSPECTION REQUESTED ° �' TIME INSPECTION REQUESTED - ° ks PERMIT NO
TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK
BUILDING: ❑ FOOTING ❑ DECKFOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL PASSED FAILED
COMMENTS:
UTILITIES: ❑
SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
PASSED
FAILED
❑
PARTIAL
❑
❑
COMMENTS:
ELECTRICAL: ❑
ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT
PASSED
FAILED
❑
PARTIAL
❑
❑
COMMENTS:
MECHANICAL: ❑
ROUGH IN A/C X FURNACE ❑ RADIANT HEAT �Q PARTIAL
PASSED
FAILED
COMMENT
7 6 o C� U 6 q T ��
El
PLUMBING ❑
GROUNDWORK ❑ ROUGH -IN ❑ ❑ WATER METER INSTALLED S 6ARTIAL
PASSED
FAILED
❑
PRESSURE TEST
❑
COMMENTS:
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS:
d to eef Gs -te. v ® e s
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY
INSPECTO s DATE OF INSPECTION MADE: ° 1.� - f b T IME 1 e/6 0 ".