|
APPLICATIG� FOR CONSTRUC7 .ON PERMIT � �
<br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT +�+'e1'�/r�•�
<br /> � H[ATINGS`'�7FM JGnS �rJ�EL[CiHIC J
<br /> �UILDWG DEPARTMENi � � - � - - ---- - -� -- - � � � � -���-- ----'
<br /> 259-8810
<br /> DEMOLITION COMBINATION BUiLDING MECHANICAL PLUMBING SIGN ^�
<br /> ,,;� — _ � � ,, , � �. � . ,; i. �� .�. . Z ", . ' � L..,,; _ -- - - I
<br /> �
<br /> .iv'irt��•_��_ Mnnnun��ess -. _�cnr 1�� roroqt '
<br /> niur�rtECTORDESM.NER MniI�D�RE55 CrtV Zi� PHOVE
<br /> � '� L4I C� «Li'1!','1�
<br /> y�H ul�u*�lCON1R�CTOR MML�D�FE55 GTY llv PN(Y!E STREIIGENSE� �
<br /> Vl�� __� �l.✓i� l��
<br /> ay ..���uNiC�LCp1TN�CTOR M�R�DO�ESS CITY TiP PHONE ST,1L.lICENSE�
<br /> A�7x
<br /> C H -
<br /> 'a HS](C ri�.�!�P,�4.Cp1iq�CtUR Mul Ap0uF55 C11Y 11P v�IONE ST�fF IICENSC�
<br /> H 9 3 -__ — —
<br /> � z� ��e�aorwonK, .
<br /> H Ctl NEW � ��ADDITION �LTERATION REPAIR OEMOLITION WOODSTOVEFRPL INSEiii BUILDING RF.LOCATION
<br /> � y� � -" „ rnvuc+orn,or�euorNor�rr�o
<br /> i"'�" �^�� �
<br /> �mMct vnicE OF WOarc /�L2:t�) � �T �T c .� ^ ' ) ___. � �J C�( .
<br /> '.'yL,' �Y.� t i s;'.ni�[WpRK�N�SOU�RF fQ)L�GE�NVOLVFD �•' � � �
<br /> �t� Q C
<br /> �']d i�:'n...�rnf Wr.�\ � ..fi ...
<br /> H�J ����asrous oFnmimr�n , � HEREBV CERTIFV THAT I HAVE READ AND E%AMINED TIy,S
<br /> O nvPLICATION AND KNOW 1HE SAME TO BE iRUE AND CORRECT 4LL
<br /> G]�O `f��` `� �"' --- - PROVIStONS OF LAWS AN�ORDINANCES GOVERNING THIS TVPE OF
<br /> --_. _
<br /> ❑ i['��nipfSCRIP ONO�Oqpnpplv�4�O�ttiNRONORAtTAGHfWACOP�E51
<br /> x H 3 ,�/ WC��K WILL BE COMPI.ETED WITH WHEiHER SPECIFlED HEREIN Oii
<br /> a y x ,; , j 4 I ry<<x-„ __a _ ` OH/O _ 9cJ-��Lnr9_ NOf THE GRANTING OF A PERMIT DOES NOT PRESUME i0 GIVE
<br /> 4
<br /> Al1Tf10qiTV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV
<br /> ty y y G�t��1�' ��/[�T �'eC�i�g,;� ✓iSluj�jN '� OTIfER S7A?E OR LOCAL LAW REGULAiMG CONSTRUCTION OR THE
<br /> � �� � "�- � � - PF.RFOF�dANCE OF CONSTRUCTItiN THAi I AM AU7HORIZED BV THE
<br /> C OWNf(7 [)F THiS PRl1PFR7� in PFFff alA THf. WORK FOR WHICH
<br /> � [�i t+ �x`�-[_13�I_���10!�f��CU if9-'-3"�'-C G'�_+yt� qpp���hTiON i5 MADF. AND I C.�I.1P V WITH THE STATE
<br /> y��� CONiRhC 7pq5 LAW ifl 77 FCW 4ND 296�AC
<br /> HOfA _ —
<br /> K r � � -�,, 11u-��.��_�z
<br /> - � � •
<br /> ,.,��,;� ���,, ,_
<br /> , ,_ , �--
<br /> ,� x < << , , , , „- � � �; , :..r-- _f: _ _ _____
<br />' PLUMBING MECNANICAI ,
<br />� NO. TVPE OF FI%TURE OR ITEM FEE NO. TVPE f,F EOUIPMENT FEE
<br />� � WAIERCI.U5F1iTO�lFil AC AIRJDIGIWI9 �+P
<br /> ._-_ ' __.. _ ____ ' __-._
<br /> � � _� _ BAT41TUf3 ...' ____ _ . �UNCFDAfRtiv if61ti HIII M EA .__.__ _
<br /> �
<br /> LAVATORV IWASfi BASIIJi UNIT IIFAiF-NS 13 T II rd _ ,
<br /> .. _ -. .__. _ - __ .. . . . . . _-_ -�_
<br /> SHOW[R CIOiHFSpRYEqti .__
<br /> i� `�' __ ___ KITCHCN SINK 8 OISP _ VF Nl ll AiION�AN '
<br /> _ T
<br /> �` � .. OISHW�SH[R RANGf I1�OD _.
<br /> .__- ._.__. _____ . . . - - --:-- i
<br /> LAUNDRV 7RI1V Wnif.qla:A1FR ;
<br /> _ . . _ _—__'_-_ _ .'_" _ _ I
<br /> CLOTHES WASHEF W(�OU570VF I
<br /> � ..__. ____..__. ._ __ _ . __ _ __-•--
<br /> � � URINAL L1f lAl I INFPIACE d CHIMNE�
<br />� � -- ___ - __ . " __ - i
<br /> DRWKING POUNIAIN �iRfPl AC[ I'ISERT ,
<br /> ____- -__.-__.. _ ._ _ . ___ --_ ' . __-._ _. r
<br />, FLOOR URAIN �tl A1 PUA�P ""______'_ .
<br /> ___ -- ' _ ____ . —_ - _
<br /> � '�' _ _ �ACKfIOWPRFVf-N1CR, GAtiPIPING . ; ���,
<br /> ___ . __-_. ' _.__ -._'_._'-_- _r_
<br /> ROOf UNAINS -MINI f AUf FS f xHAU;i FAN
<br /> . __._._._.- . . .
<br /> ;IHh i5f NVICF BAR !`if, � . ____ __ __ ____._ _ .. I
<br />' �� � _ ___ ... . . . _--_.-._ _T-- I
<br /> i
<br /> - __ _�-_
<br /> � - _
<br /> __.._______ .. .. .._____ _ . . . . — .._.—._ _..._ .._�._ _
<br /> � (�� — sue torn� s sue rorni s �___ I
<br /> _ ____ _ - ,
<br /> rrnr,ar s ' i�r�atiut s i
<br /> ruini r[� 5 � rciini i rr s I
<br /> , FOR OFFICE USE ONLY:
<br /> (Ht➢11 I�I�P�r 111�f�'.1 II���x I �! SI 111A0 i n i� ��j�.r i 1�!�� 111 lil i 1�PI Nli I
<br /> ���. ��� I Q � �1�/l ���) �
<br /> �..J �.l
<br /> us� ro�a � �w u+�n vnc�r�t srt - FEES VALUATION FEE
<br /> i� 2 i.� C�r NO ^' 7 1� ;UT
<br /> HUII I)ING
<br /> tYM01CON�5�IlOW�BIf trVlOICONSI�GIIUI a[iwv� ,-; .n. ., •,. L'`�
<br /> �0�r � PI UMI71N:� � .
<br /> — _ ____ -_ __. .__._ _. . . _ ___'
<br /> SREOF91P0 KK10f5fORICS OASEMENI 1���(;��pNICAI
<br /> ...__ .._.L.
<br />' OGCUPINGYL0�0 in�i �,I�In�ri�In�fOD 1111f.u11iMi1AunN �����IIIONN PI�NCHECN
<br /> ��, , .. . . . __-_—__ .. .__`_
<br /> � 'VI'HINNI I It �
<br /> ;�� ; MA t7�i uiNc SUnc��ni�r,r --�L�i�/-� �
<br /> . .- /, l. \ ' i � ,
<br /> PF�SOII��iR SPNNNLFn
<br /> �N�nXLBv _ �._. rin�nP�nnv���P. ,� �.� _� _ � . / V�
<br /> � CIfYOF[VERETT run�icwonks -!-
<br /> i IOCALSALES
<br /> �h { i TAX CODE IS 3105 TOTRL il%t '��
<br />
|