City of Bridgeport East Bridgeport Development Corridor 5.16.12.
CITY OF BRIDGEPORT, BUILDING DEPARMENT APPLICATION FOR PLUMBING … · 2020. 10. 26. · Form 1230...
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Form 1230 (4.3.20) Plumbing Permit No. _______ CITY OF BRIDGEPORT, BUILDING DEPARMENT APPLICATION FOR PLUMBING PERMIT Building Permit #_________ This Section To Be Completely Filled Out By Applicant HOLD HARMLESS/RELEASE City of Bridgeport and Bridgeport Building Department requires that permittee shall indemnify and hold‐harmless "City/Department", it's employees and agents and release both from any and all claims on actions brought by third parties for injuries or damages of property in connection with granting of this permit and work to be performed there under. Permittee may be required to insure against such claims in amounts appropriate to meet such obligation. City/ Department shall have the right to review and specify such amount and scope of coverage as it may deem appropriate for activities conducted under this permit. I HEREBY MAKE APPLICATION FOR A PERMIT TO DO PLUMBING WORK‐IN ACCORDANCE WITH THE BUILDING CODE‐IN A BUILDING AS HEREINAFTER DESCRIBED: Address of Work Date Nearest Cross St Owner Address Owner Address City/Town State: Zip: Use of Building Frame Masonry New Old Addition Remarks LOCATION FIXTURES B 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th Toilets Lavatories Baths Stall Showers Sinks Hot Water Heater PLUMBER MUST RECEIVE A PERMIT BEFORE COMMENCING WORK. Estimate of value $ Licensed Contractor: Receipt No. Signature Fee Business Address CT State License No. Phone Permit No._____________ APPLICATION FOR FIRE PROTECTION PERMIT Sprinklers Dry Wet Pipe Schedule Hydraulically Calculated System Demand: PSI: GPM: No. of heads: New Relocated Standpipes No: and size of risers: No. of Stories: Other Systems C0 2 Halon Chemical Other Remarks PERMIT MUST BE ISSUED BEFORE COMMENCING WORK. Estimate of value $ Licensed Contractor: Receipt No. Signature Fee Business Address CT State License No. Phone
Transcript of CITY OF BRIDGEPORT, BUILDING DEPARMENT APPLICATION FOR PLUMBING … · 2020. 10. 26. · Form 1230...
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Form 1230 (4.3.20)
Plumbing Permit No. _______
CITY OF BRIDGEPORT, BUILDING DEPARMENT APPLICATION FOR PLUMBING PERMIT
Building Permit #_________
This Section To Be Completely Filled Out By Applicant
HOLD HARMLESS/RELEASE City of Bridgeport and Bridgeport Building Department requires that permittee shall indemnify and hold‐harmless "City/Department", it's employees and agents and release both from any and all claims on actions brought by third parties for injuries or damages of property in connection with granting of this permit and work to be performed there under. Permittee may be required to insure against such claims in amounts appropriate to meet such obligation. City/ Department shall have the right to review and specify such amount and scope of coverage as it may deem appropriate for activities conducted under this permit.
I HEREBY MAKE APPLICATION FOR A PERMIT TO DO PLUMBING WORK‐IN ACCORDANCE WITH THE BUILDING CODE‐IN A BUILDING AS HEREINAFTER DESCRIBED:
Address of Work Date Nearest Cross St Owner Address Owner Address City/Town State: Zip: Use of Building Frame Masonry New Old AdditionRemarks
LOCATION FIXTURES B 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th Toilets Lavatories Baths Stall Showers Sinks Hot Water Heater
PLUMBER MUST RECEIVE A PERMIT BEFORE COMMENCING WORK. Estimate of value $ Licensed Contractor: Receipt No. Signature Fee Business Address
CT State License No. Phone
Permit No._____________ APPLICATION FOR FIRE PROTECTION PERMITSprinklers
Dry Wet Pipe Schedule Hydraulically CalculatedSystem Demand: PSI: GPM:No. of heads: New Relocated
Standpipes No: and size of risers: No. of Stories:
Other Systems C02 Halon Chemical Other
Remarks
PERMIT MUST BE ISSUED BEFORE COMMENCING WORK. Estimate of value $ Licensed Contractor: Receipt No. Signature Fee Business Address
CT State License No. Phone
Permit No: Permit: Address of Work: Date: Nearest Cross St: Owner: Address: Use of Building: Frame: OnMasonry: OffNew: OffOld: OffAddition: OffBToilets: 1stToilets: 2ndToilets: 3rdToilets: 4thToilets: 5thToilets: 6thToilets: 7thToilets: 8thToilets: 9thToilets: 10thToilets: 11thToilets: 12thToilets: BLavatories: 1stLavatories: 2ndLavatories: 3rdLavatories: 4thLavatories: 5thLavatories: 6thLavatories: 7thLavatories: 8thLavatories: 9thLavatories: 10thLavatories: 11thLavatories: 12thLavatories: BBaths: 1stBaths: 2ndBaths: 3rdBaths: 4thBaths: 5thBaths: 6thBaths: 7thBaths: 8thBaths: 9thBaths: 10thBaths: 11thBaths: 12thBaths: BStall Showers: 1stStall Showers: 2ndStall Showers: 3rdStall Showers: 4thStall Showers: 5thStall Showers: 6thStall Showers: 7thStall Showers: 8thStall Showers: 9thStall Showers: 10thStall Showers: 11thStall Showers: 12thStall Showers: BSinks: 1stSinks: 2ndSinks: 3rdSinks: 4thSinks: 5thSinks: 6thSinks: 7thSinks: 8thSinks: 9thSinks: 10thSinks: 11thSinks: 12thSinks: BHot Water Heater: 1stHot Water Heater: 2ndHot Water Heater: 3rdHot Water Heater: 4thHot Water Heater: 5thHot Water Heater: 6thHot Water Heater: 7thHot Water Heater: 8thHot Water Heater: 9thHot Water Heater: 10thHot Water Heater: 11thHot Water Heater: 12thHot Water Heater: BRow7: 1stRow7: 2ndRow7: 3rdRow7: 4thRow7: 5thRow7: 6thRow7: 7thRow7: 8thRow7: 9thRow7: 10thRow7: 11thRow7: 12thRow7: BRow8: 1stRow8: 2ndRow8: 3rdRow8: 4thRow8: 5thRow8: 6thRow8: 7thRow8: 8thRow8: 9thRow8: 10thRow8: 11thRow8: 12thRow8: BRow9: 1stRow9: 2ndRow9: 3rdRow9: 4thRow9: 5thRow9: 6thRow9: 7thRow9: 8thRow9: 9thRow9: 10thRow9: 11thRow9: 12thRow9: BRow10: 1stRow10: 2ndRow10: 3rdRow10: 4thRow10: 5thRow10: 6thRow10: 7thRow10: 8thRow10: 9thRow10: 10thRow10: 11thRow10: 12thRow10: Estimate of value: Licensed Contractor: Receipt No: Signature: Business Address: Permit No_2: Dry: OffWet Pipe: OffSchedule: OffHydraulically Calculated: OffC02: OffHalon: OffChemical: OffOther: OffEstimate of value_2: Licensed Contractor_2: Receipt No_2: Signature_2: Business Address_2: Owner Adress: City/Town: State: Zip: Fixtures - Other Row 1: Fixtures - Other Row 2: Fixtures - Other Row 3: Fixtures - Other Row 4: CT License No: Standpipes No and size of risers: No: of Stories:
PSI: GPM: Relocated: New heads: Other System: Remarks: Fee: Fee_2: Ct License: Phone:
