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f'�'+,{`I,+Y�:;,kj"tfn'y�y"�?'k,'��.:�:�. "^i�.. `�'���yi�A&!�:i'�,ry db5r� �t '. � <br /> t, • <br /> e: <br /> '�� �� �G� pppLICAYIO�FOR COI�lSTRUCTI�N PERMIT � � ` <br /> ^ TO BE CUMPLETED IN BLACK INK—PLEASE PRINT 1 <br /> HEATINO SYSTEM U GAS ❑ELECTRIC ❑ — I <br /> ^��q BUILDING DEPARTMENT — i <br /> 259•8810 <br /> t] ECHANICAL �PLUMBIN(3 i I SION ' � <br /> C� I I DEMOLITION i I COMBINATION BUILDING � � � <br /> MNL�DDPE35 Clry Z1P P�E W�- 98/z4 ��a 1 <br /> ��t+ ' ��EI NG � RPX 37D—I 1`1 �`�F--7(0 5�/�7TLF <br /> I 7EW11T IMIL�DORE59 <br /> CITV LIP PIIONE <br /> �Q�� QLV Z•p PHOHE �- ;. <br /> I� 11KNITECidi0E61�NEN MAILAODNf55 <br /> .n�� �.� OENEIIALCONTIUGTOR MARAUDRb: GITV 21P PHdIE STATELIGENSEI f <br /> °� ``- I EQ C 2U LE W I <br /> y��µl�LCqlTp/�CTpp MAKADDRESS GITV 21P PHqIE ST�TEIIf.ENSt1 <br /> g— A�Reoci �3t K <br /> �A � CCO �35 /J. �ENre��. AV� t�13Z _L4E�r wk 9$03;'- fjSA-b444 Q • <br /> Or WIL/�DGdE55 CRV 21P PH011E STATELIGENSE� <br /> AUTABMO LONTMCT.MI <br /> . �� �, CUu90iWORR . <br /> � �j� y� I I NEW I 1 ADDITION �'qLTERATION '� �. REPAIR � DEMOLITION � : WOODSTOV6FRPL INSERT I I BUILD�NO RELOCATION <br /> COlIT�CT PERSON N10 PHONE NO <br /> � � � �j2(j ppb E L}� LDC�'AM <br /> � cor+rwcr rnwe or won <br /> . �� E6UkE NIJIUBOU�PEF00111 INV YED��nRLL A�W I�R�CK� (�r � f� <br /> — � �4or e, �..,,�y�.�s+rn,..`�,ea�`,�...i�eA ���r�Co�r�,.a;c� r�0lo> V.Y�—U44Q <br /> b ' I HEREBV CEflTIFY THAT I HAVE READ AND EXAMINED THIS <br /> — � vnoroseou eocaun ua � pppLICA710N AND KNOW THE SAME 70 BE TRUE AND CORRECL ALL <br /> ; �"eM&.�NG �In 7 S pROVISIONS OF LAWS AN�ORDINAM10ES GOVERNING THIS TVPE OF <br /> 1[ �a�f`f6Gq�eTpqp{pROiE.'1TVI��BEIOWOF�T7ACNfWPCO�iE51 yrORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OH , <br /> � ! �or e�oac o� — NOT. THE GRANTING OF A PERMIT D�)ES NOT PRESUME TO OIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> F OTHER STATE OR LOCAL LAW REOULATINO CONSTRUCTION OR THE <br /> i PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHOHIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOfi WHICH <br /> j APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> + CONTRACTORS U1W 18.27 fiCW AND 296200 WAC. . <br /> � BoriN� x �7�`�- o� d0�! 1-Z3-� Z <br /> . Y 6��. 4c-33 scw.udi"� wrz A C �i <br /> � PPOIECT/i00RE55 - � E� � <br /> �� f 3oa3 W• C o � �,r��s,�K��E� <br /> ` ��� NECHANICAL � <br /> j FEE <br /> J I Np, TNpE OF fl%TUHE OR ITEM fEE NO. TYPE OF E�UIPMENT <br /> , WATEH CLOSET(TOILE� A/C—A/HNDLG UNITS—H.P. �. <br /> � � BATHTUB _ FORCED AIR SVSTEMS—B.T.U. M E.A. <br /> UNITHEATEPS—B.TU. M _ �i <br /> ? � C'I. UVATOFV(WASH BASIN) CLO�nc5 DRVEHS <br /> ; SHOWEH � <br /> VENTILATION FAN <br /> �� � . KIICHCNSINKBDISP pqNGEHWD " <br /> , : DISHWASHER <br /> � �!; LAUNORVTRAV WATERHEATER _ <br /> � J CLOTHES WASHER WOOD STOVE <br /> METAI FIREPLACE 6 CHIMNEY <br /> , URINAL FIREPLACEINSERT � � <br /> � �I DRINKING FOUNTAIN HEF,T PUMP . <br /> I �� FLOOR DRAIN GAS PIPING � <br /> BACKFLOW PREVENTERS E%HAUSTFAN <br /> ROOF DRAINS—RAINL[ADERS <br /> i � SINK(SERVICE—BAR,ETC.) � : <br /> � �, . ME GE s _ 0 1 _ , <br /> ; 2 � 5'T P P- <br /> I � SUBTOTAL E '�� 1 — SUBTOTAL S ' — <br /> PERMIT S PERMIT S � � <br /> � � E -- TOTAL FEE f G' ' TOTAL FEE S 'Ou <br /> � FOR OFFICE USE ONLY: nEceivT No <br /> - ipq1T5ET8AGK AEAHSETBACK SIDESEIB�CN PUNCHEC NUMBER � FEE <br /> � USElONE ��T�RE� <br /> veciwtSirE FEES VALUATION FEE <br /> BUILOING <br /> IYPEqCONfS.�lL0V1�81E IYPEOILOMSIACiWI a[cvracr xanomwx4uxns � <br /> c"� PLUM9ING ' d� <br /> SIZEOFBlf16 NOOFSTORIES BASEMENf MECHANICAL � '�� <br /> � ADDITIONAL PLAN CMECN ' <br /> OCCUCANGYL�MD FIRESPRNNlER5RE00 MEiGNLLIMIiAtION — � I <br /> SPflINKLER <br /> nEASON�oRSPRWKlEnS SiATE BUILDING SURCHARGE <br /> Ih1A1(EBV P SAPPROVE�OY CITYOFEVEHETT PUBLICWORNS <br /> LOCAL SALES 3 a G s` ; Oa <br /> T�xcooeis3�as TOTAL � <br />