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Home My WebLink About140 Del Guzzi Drive Address: 140 Del Guzzi Drive PREPARED 12/24/14, 11:04:52 INSPECTION TICKET PAGE 2 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 12/24/14 ------------------------------------------------------------------------------------------------ ADDRESS . : 140 DEL GUZZI DR SUBDIV: CONTRACTOR TOM'S PLUMBING INC. PHONE (360) 683-8336 OWNER TODD E MCCLASKEY JR TIE PHONE PARCEL 06-30-12-3-4-9030-0000- APPL NUMBER: 14-00001524 PLUMBING PERMIT ------------------------------------------------------------------------------------------------ PERMIT: PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ PL2 Ol 12/ JLL PLUMBING ROUGH-IN December 24, 2014 8:32:43 AM pbarthol. Jason 452-2993 PL99 01 12/24/14 JLL PLUMBING FINAL December 24, 2014 8:33:06 AM pbarthol. Jason 452-2993 -------------------------------------- COMMENTS AND NOTES -------------------------------------- i CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT- BUILDING DIVISION ® 321 EAST 5TH STREET, PORT ANGELES, WA 98362 t v^ N' Application Number . . . . . 14-00001524 Date 12/19/14 Application pin number . . . 245296 Property Address . . . . . . 140 DEL GUZZI DR ASSESSOR PARCEL NUMBER: 06-30-12-3-4-9030-0000- REPORT SALES TAX Application type description PLUMBING PERMIT Subdivision Name . . . . . . on your state excise tax form Property Use . . . . . . . . to the City of Port Angeles Property Zoning . Application valuation . . . . 973 (Location Code 0502) ---------------------------------------------------------------------------- Application desc COMMERCIAL GREASE INTERCEPTOR ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ TODD E MCCLASKEY JR TTE TOM'S PLUMBING INC. 656 OFFICERS ROW PO BOX 1149 VANCOUVER WA 986613836 SEQUIM WA 98382 (360) 683-8336 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . GREASE INTERCEPTOR Permit Fee . . . . 57.00 Plan Check Fee .00 Issue Date . . . . 12/19/14 Valuation . . . . 0 Expiration Date 6/17/15 Qty Unit Charge Per Extension BASE FEE 50.00 1.00 7.0000 EA PL-IND WASTE PRETREAT INTRCPTR 7.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 57.00 57.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 57.00 57.00 .00 .00 W Separate Permits are required forelectrical work,SEPA,Shoreline,ESA,utilities,private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days,if construction or work is suspended or abandoned for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the last inspection. 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 state or local law regulating construction or the performance of construction. 04 MM-U- Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder) T:Forms/Building Division/Building Permit BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS -- Building Inspections 417-4815 Electrical Inspections 417-4735 Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments FOUNDATION: Footings Stemwall Foundation Drainage/Downspouts Piers Post Holes(Pole Bldgs.) PLUMBING: Under Floor/Slab Rough-In Water Line(Meter to Bldg) Gas Line Back Flow/Water FINAL Date Accepted b AIR SEAL: Walls Ceiling FRAMING: Joists/Girders/Under Floor Shear Wall/Hold Downs Walls/Roof/Ceiling Drywall(Interior Braced Panel Only) T-Bar INSULATION: Slab Wall/Floor/Ceiling MECHANICAL: Heat Pum /Furnace/FAU/Ducts Rough-In Gas Line Wood Stove/Pellet/Chimney Commercial Hood/Ducts FINAL Date Accepted b MANUFACTURED HOMES: Footing/Slab Blocking&Hold Downs Skirting PLANNING DEPT. Separate Permit#s SEPA: Parkin /Lighting ESA: Landscaping SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE Inspection Type Date Accepted By Electrical 417-4735 Construction- R.W. PW / Engineering 417-4831 Fire 417-4653 Planning 417-4750 Building 417-4815 T:Forms/Building Division/Building Permit THFFor City Use 10 ' S, -T CH-Ty OF i R , P�f-- ANG ,�LIF Permit# w S H I N G—-r 0 N, U . S. Date Received: 9- 14 321 E Slh Street Date Approved 54, Port Angeles,WA 9836 P:360-417-4817 F: 360-417-4711 Email: permits0cityofl2ams BUILDING PERMIT APPLICATION Project Address: Jq0 qg,Q(sz Phone: 3 Z- Z993 Primary Contact: Email: JplaQrJ, .L Name W L--<,l Phon t'' (cis) Property -M *1* Address Email Owner I qqq S. e —t-rj�- UJ'� 0, Cit State ZiP98( OF Name, Phone(,,, IPW�^N Contractor Address Email v'()� W K (k Y-13 Information City S' Q QQ w\ . State CAA zip 9 e'36 Z Contractors License#Tom Exp.Date: *9S I Legal Description: Zoning: Tax Parcel # Project Value: (materials and labor) I $ ql_s 1 00 Residential ❑ Commercial Industrial 11 . Public 11 Permit Demolition El Fire El Repair 9----Reroof(tear off/lay over) ❑ Classification For the following, fill out both pages of permit application: (check New Construction 11 Exterior Remodel 11 Addition 11 Tenant Improvement ❑ appropriate) Mechanical El Plumbing Other 1:1 Fire Sprinkler System? Irrigation System? posed Bathrooms Proposed Bed ooms Yes 0 No 6k� Yes E3 No 2! 11-J A--- Project DescriptionJMSL)LL8� Gt-- hitJ Is project in a Flood Zone: Yes [3 NoM-�Flood Zone W Type: If in a Flood Zone, what is the value of the structure before proposed improvement? $ 1 have read and completed the application and know it to be true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required and to obtain permits prior to work. I understand that plan review fees are not refundable after review has occurred. I understand that I will forfeit review fees if I withdraw the application before the permit is issued. I understand that if the permit is not picked up/issued within 18o days of submittal,the application will be considered abandoned and the fees will be forfeited. 01�V� K w .1 ��1 �`fifii 1 Date Print Name Signature Residential Structures For Office Use Area Description(SQ FT) Existing Proposed ss value Basement First Floor Second Floor Covered Deck/Porch/Entry Deck(over 30"or a" floor) Garage Carport Other(describe) Area Totals Commercial Structures For Office Use Area Descriptions(SQ FT) Existing Proposed S$Value Existing Structure (s) Proposed Addition Tenant Improvement? Other work(describe) Site Area Totals Lot/Site Coverage Calculations Lot Size(sq ft) Lot Coverage(sq ft) %Lot Coverage(Total lot coverage_lot size) Site Coverage (Sq Ft of all impervious) %of Site Coverage(total site coverage_lot size) Mechanical Fixtures Indicate how many of each type of fixture to be installed or relocated as part of this project. Air Handler Size: # Haz/Non-Haz Piping Outlets: Appliance Exhaust Fan # Heater(Suspended,Floor,Recessed wall) # Boiler/Compressor Size: # Heating/Cooling appliance # re air/alteration Evaporative Cooler(attached,not # Pellet Stove/Wood-burning/Gas # portable) Fireplace/Gas Stove/Gas Cook Stove/Misc. Fuel Gas Piping #of Outlets: Ventilation Fan,single duct # Furnace/Heat Pump/ Size: # Ventilation System # Forced Air Unit Plumbing Fixtures Indicate how many of each type of fixture to be installed or relocated Plumbing Traps # Fuel gas piping #of Outlets: Water Heater # Medical gas piping #of Outlets: Water Line # Plumbing Vent piping # Sewer Line # Industrial waste pretreatment interceptor Grease Trap) Size Other(describe): T:\BUILDING\APPLICATION FORMS\Current BP Application\Building Permit 4-17-13.docx Address: 140 Del Guzzi Drive PREPARED 12/24/14, 11:04:52 INSPECTION TICKET PAGE 1 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 12/24/14 ------------------------------------------------------------------------------------------------ ADDRESS . : 140 DEL GUZZI DR SUBDIV: CONTRACTOR AIR FLO HEATING CO INC PHONE (360) 683-3901 OWNER TODD E MCCLASKEY JR TIE PHONE PARCEL 06-30-12-3-4-9030-0000- APPL NUMBER: 14-00000262 COMM MECHANICAL PERMIT ------------------------------------------------------------------------------------------------ PERMIT= ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ ME99 01 12/24/14 JL MECHANICAL FINAL December 24, 2014 8:40:56 AM pbarthol. -------------------------- ---- ------ COMMENTS AND NOTES CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY& ECONOMIC DEVELOPMENT- BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 48362 Application Number . . . . . 14-00000262 Date 3/05/14 \ Application pin number . . . 545316 Property Address . . . . . . 140 DEL GUZZI DR ASSESSOR PARCEL NUMBER: 06-30-12-3-4-9030-0000- REPORT SALES TAX Application type description COMM MECHANICAL PERMIT Subdivision Name . . . . . . on your state excise tax form Property Use . . . . . . . . to the City of Port Angeles Property Zoning . �, Application valuation . . . . 18794 (Location Code 0502) ---------------------------- Application desc REPLACEMENT LIKE IN KIND HEAT PUMP UNITS ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ TODD E MCCLASKEY JR TTE AIR FLO HEATING CO INC 656 OFFICERS ROW 221 W. CEDAR VANCOUVER WA 986613836 SEQUIM WA 98382 (360) 683-3901 ----------------------------------=-------------------- --------------- Permit . . . . . . MECHANICAL PERMIT Additional desc TWO HEAT PUMP PACKAGE UNITS RP Permit Fee . . . . 79.60 Plan Check Fee .00 Issue Date 3/05/14 Valuation 0 Expiration Date 9/01/14 Qty Unit Charge Per Extension BASE FEE 50.00 2.00 14.8000 EA ME-FURN/HP/FAU < OR = 5 TON 29.60 ----------------------------------- ------ Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---- Permit Fee Total 79.60 79.60 .00 .00 Plan Check Total .00 .00 Grand Total 79.60 79.60 .00 .00 Qthl Separate Permits are required for electrical work,SEPA,Shoreline,ESA,utilities,private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days,if construction or work is suspended or abandoned for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the last inspection. 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 state or local law regulating construction or the performance of construction. Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder) T:Forms/Building Division/Building Permit BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS— Building Inspections 417-4815 Electrical Inspections 417-4735 Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886 IT IS UNLAWFUL TO COVER,INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments FOUNDATION: Footings Stemwall Foundation Drainage/Downspouts Piers Post Holes(Pole Bldgs.) PLUMBING: Under Floor/Slab Rough-In Water Line(Meter to Bldg) Gas Line Back Flow/Water FINAL Date Accepted b AIR SEAL: Walls Ceiling FRAMING: Joists/Girders/Under Floor Shear Wall/Hold Downs Walls/Roof/Ceiling Drywall Interior Braced Panel Only) T-Bar INSULATION: Slab Wall/Floor/Ceiling MECHANICAL: Heat Pum /Furnace/FAU/Ducts Rough-in Gas Line Wood Stove/Pellet/Chimney Commercial Hood/Ducts FINAL Date Accepted b MANUFACTURED HOMES: IFootinq/Slab !Blocki;q&Hold Downs Skirting PLANNING DEPT. Separate Permit#s SEPA: Parkin /Lighting ESA: Landscaping SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE Inspection Type Date Accepted By Electrical 417-4735 Construction- R.W. PW /Engineering 417-4831 Fire 417-4653 Planning 417-4750 Building 417-4815 T:Forms/Building Division/Building Permit I KE C!9`Y OFCOT For City Use W A S H 1 N G T O N, U . s . Permit# Date Received: 321 East Sm Street , Port Angeles, WA 98362 Date Approved P: 360-917-4817 F: 360-4174711 PerMitS@)cItyofpa.us Building Permit Application Project Address: 140 DEL- &k)s-L I I'Z Main Contact; Phone# Gv41 T'i't G I-C E-Mail: 31a0 Property Name O Ly ik A t G LO � O�% Pho°e Owner nwu Address ` 4 5-X- G l E toe L' (s V ZZ.1 D . cic, 0 f � Cl Contractor Name �1 P V--`.p E AT t Pbone (b Naillog jid- s, t WCEDi�� $ -re-cef � s Q �kM state D vJ � q$3ga Contractor License# Expiration: �49,F-L—1 �(Q D & L+ Project Value: Zoning: Tax Parcel# Lot# Type of Residential ❑ Commercial lndustriai ❑ Public ❑ Permit Demolition ❑ Fire ❑ Repair ❑ Reroof(tear off/lay over) ❑ For the following,fill out both pages of permit application: New Construction ❑ Remodel ❑ Addition ❑ Tenant Improvement ❑ Mechanical ML Plumbing ❑ Other ❑ E fisting Fire Sprinkler System? Maximum beigbt of structure Proposed Bedrooms Proposed Bathrooms Yes ❑ No ❑ Project Description L �-� F IT I have read and completed the application and know it to be true and correct I am authorized to apply for this permit. I understand that it is my responsibility to determine what permits are required and to obtain permits prior to worldng on projects I understand that the plan review fee is not refundable after plan review has occurred. I understand that I will forfeit the review fee if I cancel or withdraw the application before the permit is issued. I understand that if the permit is not issued within 180 days of receipt,the application will be considered abandoned and the fees forfeit Date Print Name Signature fit-M E 91 00 T -d ILGE 689 096 0-1A bIU WHb9 :01 t102 b0 Jew Area Description(SQ F1) Residential Structures E5tiy�0iIIg Proposed SS value For OfSoe Use Basement First Floor Second Floor Covered Deck/Porch/Entry Deck Garage Carport Other(describe) Area Totals COmn'lercial Structures Area Descriptions(SQ M For Office Use �°S°g Proposed $S Value Ensting Stnrctur+e(s) Proposed Addition Tenant Improvement? Other work(describe) Area Totals Footprint(SQ FTJ ofd Strntmres: LatlSite Coverage Calculations Lot Size: °/6 Lot Coverage SQ FT Site coverage(all impervious+ strvctnres - 'fib 51te Coverage Indicate how mm an ofeaMechanical Fixtures Air Handler a of to be installed or relocated as Dart of this ro Size: 41 Haz/Non•Haz Piping Appliance yeast #of Outlets: # Heater(Suspended,Floor,Recessed wail) # Boiler/Compressor Sizer # Heating/Cooling appliance Evaporative Cooler(attached,not re r alteration # ortable # Pellet Stove/Wood_burning/Gas # Fuel Gas Piping #of Outlets: Fire lace s Stove Gas Cook Stove Misr. Ventilation GaFan, Furnace/Heat Pum # Forced Air Unit P/ Size: # ^ single duct Ventilation System # Indicate bowman of each Plumbin Fixtures Plumbing 7Taps of fixture to be installed or relocated # ater Hear Fuel gas piping Wte #of Outlets; # Medical gas piping Water Line #of Outlets; # 'Vent piping Sewer Line # # Industrial waste pretreatment # Other describe : interce for T:\BUr1.D111G`APPLICATlON PORMSIBU[LDQdG PBRMrr 081212.DOp( 2 'd ILSE E89 096 01A NIH WHbS =Ot bTOZ b0 Jew i HE CITY OFJML City Use .:. W A S H I N G T O N , U . S . Permit# 321 East Sm Street Date Received: j Port Angeles, WA 98362 Date Approved P: 360417-4817 F: 360.417-4711 permitsC@dtyofpa.us Building Permit Application Project Address: 140 DEL 6V zz t �R\�iZ Main Contact: Phone# GE41 TT t G I-C E-Mail: 316 0- q 1 a Property Mame 0 Ly µ p l c LO D(o L Phone Owner Ka- Addrem; 5 - G 1 L) Email , city State F7'—pci 6 RTg a� Contractor Kane 1 FLS E Al t hi Phone (019 Naillcg Address` $� -t 1 -4120 W. Cc-flfi� TC116EI W • City SV-Q U% M suft vJ 9D g 4 g a Contractor License# Expiration: �IQF►-1 Xo(e D & L+� )65 Project Value: Zoning: Tax Parcel# Lot# $ 1 rDemolition . � Type ofential l7 Commercial industrial ❑ Public ❑ Permit ❑ Fire ❑ Repair ❑. Reroof(tear off/lay over) ❑ he following,fill out both pages of permit application: New Construction ❑ Remodel ❑ Addition ❑ Tenant Improvement ❑ Mechanical W Plumbing ❑ Other ❑ E dsting Fire Sprinkler System? Maximum heigbt of structure Proposed Bedrooms Proposed Bathrooms Yes ❑ No E3 Project Description L I have read and completed the application and know it to be true and correct:I am authorized to apply for this permit. I understand that it is my responsibility to determine what permits are required and to obtain permits prior to worlong on projects. I understand that the plan review fee is not refundable after plan review has occurred. I understand that I will forfeit the review fee if I cancel or withdraw the application before the permit is issued. I understand that if the permit is not issued within 180 days of receipt,the application will be considered abandoned and the fees forfeit Date Print Name Signature W,�14 qAA----' T -d i L6E E89 096 0-JJ H I U WdbS :0 i b T 02 t+0 JL Residential Structures Arra Description(SQ laois'ting proposed SS value For Office Use Basement First Floor Second Floor Covered Deck/porch/Entry Deck Garage Carport Other(describe) Area Totals Commercial Structures Area Descriptions(SQ VnFor Office Use �O Proposed �S Value Existing Structure(s) Proposed Addltlon Tenant improvement? Other work(describe) Area Totals Footprint($Q FT)of all Structures, �otlSite Covera a Calculations Lot Size: �Lot Coverage SQ FT Site coverage(all impervious F structures �b Site Coverage lodicateho, of eachMechan!Cal Fixtures Air Handler a oEfixture to be installed orrelocated as of this ro # /N A Hazon-Haz Piin pg PPliance Vent Size: #of Outlets. # Heater(Suspended,Floor,Recessed wail) # Boiler/Compre�r Size: # Heating/Cooling appliance EVaporative Cooler(attached,not re r alteration # ortable # Pellet Stove/Wood-burning/Gas # Fuel Gas Piping Fire lace Gas Stove Gas Cook Stove Misc- #ofOutlets: Ventilation singl Furnace/Heat Pump/ Se dud Size: Fan, # Forced Air Unit # ^ Ventilation System # Indicate how man of each Plumbin Fixtures Plumbing I-raps of fixture to be Installed or relocated # Fuel gas piping Water Heater #of Oudetr. l # Medicagas piping Water Line #of Outlets: # Vent piping Sewer Line # # Industrial waste retce Other de iinterce for p afinent # scribe T:\BU11.DIfl►G`ApPUGTION PORMS�BIIQ.DQ�IG PBRMlT 08121LDOpr Z 'd IL6E 689 09E 01j diu Wdb9 :01 bIOZ b0 Jew Address: 140 Del Guzzi Drive ej� IbP e�r- R-4u 94c.V, CIT ORTNGELES CITY OF For City Use Permit# Date Received: 1 Y , 321 East 51h Street p Date Approved Port Angeles, WA 98362 O p Ild P: 360-417-4817 F: 360-417-4711 L E permits@cityofpa.us u 'Cj(�,ti4�lk�'S L'�.,�I.L i:�L6�, Building Permit Application 3 3 .. Project Address: ��'zr � Cbz-2-I f�'� ,F}-r•�Y [�$ ,� Main Contact: Phone # 3�- F 0 0 x'11 C CA& s — E-Mail:.Fb Property Na a Phone Owner Mailin Address Email 1&-&,e .�✓l City State n Zip &� IA Contractor Name1r Phone Mailing Address Email ,. cityI� \ stu `"/F Stated // Zip Contractor License # / . , ` ` 1L' ,J�xpiratian: Project Value: Zoning;' Tax Parcel# /� Lot# b 94 Type of Residential ❑ Commercial .Industrial ❑ Public ❑ Permit Demolition R Fire ❑ /Repair 1:1Reroof(tear off/lay over) Eli)h For the following,fill out both pages f permit application: New Construction 11 Remodel Addition ❑ Tenant Improvement ❑ N echanical ❑ Plumbing ❑ Other El Existin ire Sprinkler System? Maximum height of structure/ Proposed Bedrooms Proposed Bathrooms ❑ / Yes No �. 'C <__� E%��7v' . Project Description I have read and completed the application and know it to be true and correct.I am authorized to apply for this permit. I understand that it is my responsibility to determine what permits are required and to obtain permits prior to working on projects. I understand that the plan review fee is not refundable after plan review has occurred. I understand that I will forfeit the review fee if I cancel or withdraw the application before the permit is issued. I understand that if the permit is not issued within 180 days of receipt,the application will be considered abandoned and the fees forfeit. Date Print Name Signature l o/ Residential Structures For Office Use Area Description(SQ FT) Existing Proposed $$value Basement First Floor Second Floor Covered Deck/Porch/Entry Deck Garage Carport Other(describe) Area Totals Commercial Structures For Office Use Area Descriptions(SQ FT) Existing Proposed $$Value Existing Structure(s) Proposed Addition Tenant Improvement? Other work(describe) � bbd Area Totals rco Lot/Site Coverage Calculations Footprint(SQ FT)of all Structures: Lot Size: %Lot Coverage SQ FT Site coverage(all impervious+ / J %Site Coverage structures Mechanical Fixtures Indicate how many of eaEh t3rpe of fixture to be installed or relocated as part of this project. Air Handler Size: # Haz%Non-Haz Piping #of Outlets: Appliance V-gnt ° (7�/1�Z t�e0 # 1 Heater(Suspended,Floor,Recessed wall) # ^ F. I Boiler/Compressor Size: # Heating/Cooling appliance # _ repair/alteration Evaporative Cooler(attached,not # _ Pellet Stove/Wood-burning/Gas # portable) Fireplace/Gas Stove Gas Cook Stove/Misc. Fuel Gas Piping #of Outlets: Ventilation Fan,single duct # ., Furnace/Heat Pump/ Size: # Ventilation System # Forced Air Unit 3 261#C'e' d Ma 4 UPAK /qnz-70-A) Plumbing Fixtures Indicate how many of each t3rpe of fixture to be installed or relocated Plumbing Traps # Fuel gas piping #of Outlets: Water Heater # Medical gas piping #of Outlets: Water Line #Fi4'/S�wli Vent piping # VS Sewer Line # Industrial waste pretreatment # fY, interceptor Other(describe): A�Ac •N��s2C�o9 T:\BUILDING\APPLICATION FORMS\BUILDING PERMIT 081212.DOCX