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�.w�� <br /> APPLIC�rION FOR CONSTR4.:TION <br /> PERMiT <br /> t�x E verpreei rv�•�r�� <br /> ��r�o� e <br /> e�er��tt <br /> BUILDING OEPAR?MENT <br /> �c� �i 259 e810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> � � UWNLP IA�IIAI)l1NESS l�l� ill� PMIINI ' . <br /> � N IENAN�S ��s�.��-l�L-�f������ �r�F� �K s�f��_��_- 4��s-� � 33����s� <br /> Mu�eoo��Ess �� t'.ur _ . zir vneiU <br /> fl �� <br /> p.� 'j --—__..._ .___—__.__—_—_ ---___ <br /> e � �HCHIIECiUN�ESiGNEP I/ MNL�OUPESS GtY ZIP 1'HONE <br /> � �1 <br /> � � OENEA�LCONfPACiON / , M�IL�DO�ESS Ci1V PP VNOHE IICENS[� <br /> V� � l ldF�`YqJl�l=[`�d�l/ <br /> Z MELH�HIG�LCONIP/.C100 M�IL�UUflE59 GiY 21G P�IONf LIGtN E• <br /> �O � __ <br /> H <br /> � �"� pLUM9iNOGONLN1CiJ� M�RApOR[99 CrtY IIP P��ON! IIf.ENSC• <br /> �� g _,ZZr S PLur���� c, — ------ ---1'�� `s-6 � <br /> H CUSS Of WJPN <br /> ~ ❑ NEW ❑ RDDITION ❑ ALTERA710N ❑ REPRIR ❑ OEMOL1710N ❑ WOODSTOVF/FRPL INSERT ❑ BUILDING REIOGATION <br /> zy <br /> --— _. <br /> iCN�Ni IMG110VEMENi OP INiEPiOH FEMO�EL ONLY CON I�Ct PEPSON�NO PNONE NO '''j <br /> yy f,ONiRACIPRICEOFWOPII -��C'�L-J-L{-�- ���--�0 <br /> H OESLRIBEWORM�NOSOU�AEfOpGGEINVOWF� <br /> g"ti /�1.��n8l�l1G - /�_�� ��S.t�Lurn�!_N_Lz=-�`� g `s �-�- <br /> �� vnorosEous[o�em�uiNa � ` i�1EREBYCERTIFV'NATIHAVEREADANOE%AMINEDTHISAPPLICATIONAND <br /> S/NG�.�� M/L � � J KNOWTHESAMETOBETRUEANDCORPECTALLPROVISIONSOFLAWSAND <br /> y 0� pRDINANCES GOVERNING TMIS TYPE OF WORK WILL�F COMPLETED WITH <br /> LEO�L�ESCRiGiiON(NFPOPCNtY19HOWNBEIOWOP�ITAGHfGUALO>IFS� �yHETHERSPECIFlEDNEREINORNOT.7HEGAANTINGOFAPERMITDOESNOT <br /> PRESUME TO GIVE AUTHORI7V TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> �pr� e�ocK_- oa ----- ANYOiMERSTATEORLOCALLAWREG'ILATINGCONSTRUCTIONORTHEPER- <br /> FORMAIlCE OF CONSTRUCTION THAT I A�'PUTHORV.ED BV THE OWNER OF <br /> TNIS Pf70PERTV TO PLAFORM THE WORN FOR WHILH APPLICATION IS MADE <br /> AND I COIdPI.V WIT11 THE STATE CONTRACTORS LAW 1827 PCW AND <br /> 296200 WAC <br /> s�eNema�oicrnnn.co�.-r�.oun>n¢eo�eem wrc <br /> �o,E�,____���- �a� �R���— ",,�. ��,-.a �t�S�,�E�S� USiNE55N.����� <br /> f vF .� w <br /> PLUMBINO MECHANICAL <br /> ryp, TYPE OF FI%TURE fJR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> ���� �,2 WATERCLOSET�TOILEp NC-A/NNOLGUNIiS-HP <br /> -.--�Q_ -_ _"__. _-__' ___-_'--___ ____ ____ --_ <br /> ���'� BATMTUB _ __��f_ .'-ORCEDAIRSYSTEMS-BT.0 MEA _ __ ___ <br /> _ _ ----_ <br /> _ - -_ ' ___ '.__. -__—_'_'_---_ -_.' _ <br /> � ,1 LAVATORVIWASHBASINI ___- - --- --_ UNIiNEATERS BTU"-" "- - __ - - -_- <br /> _�-_- '__'-__'_-_____ <br /> S/IOWER _ GLOTFESDRVERS _ __ _ <br /> � VENTILATION FAN _ _ ___ <br /> KITCMF.N SINKB DISP. <br /> � DISHWASMER _ RANGE HOOD _ ` � <br /> i I�_I � -- -_ __ _l_ _WATEfl NEAiER - -_—__ -____" __ _..__(Q SU- <br /> LAUNDRYTRAV . ' - <br /> � CLOTHES WASMER _�_____ N'000 STOVE <br /> � URINpL _ ___ _METALFIREPLACEdCHIMNEV _ _ __ <br /> I �� ORINKINGFUUNTAIN _-- -_-__- FIREPLAC[IYSER7.---_--_ -'_-___ _'_ __ _ <br /> ��' FLOOR DRAIN NEAT VUMP <br /> BACKFLOW PR[VENTERS _ _ GAS PIPING __ _ ___ ____. <br /> ROOFDRAINS-RAINLEPDERS E%HAUSTFAN __ ____ <br /> — __ _-_ <br /> , '_' SINK�SERVICE-BAP.ETCI -- - -'-��' <br /> I, '�I�� . -- - -' -___- . . __.. <br /> _-_ _ --. ._ <br /> ' SU�TOTAL S - � ' ..__' _ .SUBTOTAI . _ _._ 5 _. __ ___. <br /> ' — ---___-- - . _ <br /> PEPMIT S . . . . PF.(iMll 4 <br /> . _._._ __..-_'- -_'_ <br /> TOTALFEE 5 - �' �-- "- ' � ��� IOTnLF[E � b <br /> I-_1_� 1NOMSEI9�CF �F�NSCitlACM SIULSCIIIICY V4NCHECMNIIMBER fEE PfCEIPTNO <br /> ' usEzoNe ior�ac� �� v.cei�isn[ FEES VALUATION FEE <br /> �.�. r�s :i r�o <br /> _'_ _____.__ _ ___' . BUILUING <br /> rvPEOfLON51 OLCUPANCYOW1iP NOO��WfLLING�W15 . -. . . _. . . - IJ( <br /> •uOWeBIE��QUeL PWMBING ( / � <br /> " _.____ .. _ ._ . . .. - <br /> SiZC Of BlDO NO Of SIURR 5 BSMI OCL LWO - <br /> ii� MECNANICAL ,�� S�� <br /> I1 N —' _.- _.. _ . <br /> - —- �- nf�att uMnenor� OTHER <br /> ___. <br /> rmesvniwKieesarn�mm� ves '. Ho g7ATFBUIIDINGSURCHARGE <br /> tiTFTt ENEFGY SURCNARGC. <br /> -u,�vC;F.��,�.�i. n. 'i i elis.vva or - I <br /> PUBLIC WORNS <br /> ' TOTAL �� in <br />