Laserfiche WebLink
APPLICATIQ �PFOR CONSTRUCTNT IVi PERMIT � <br /> f HEATING SYSTEM: J GAS J ELECTAIC J .__ _____ <br /> BUiLDING CEPARTt:EN7 _ I � <br /> 259-E810 <br /> DEMOLITION COMBINATION '�BUILDING MECHANICAL PLUMBING SIGN <br /> ���E' �,� NAIIh�DR[55 C:tY :iP YiG!!E � <br /> 2� I IaQ,�.f ¢S � 29 �U C��� �-c�c:2e rr L�n � �'2�1 _?Sg-y 3 �Y <br /> 'L+ANi MAIL/•DDRESS CITV Iiv PNONE <br /> Chcrrti �,2¢i<(�� �01 C�c$Y �uc:e��tt" r,,n q�"a� l <br /> 4RCNIT CT OESIGNEA IAAILA��AESS LRY ZIP P�E <br /> (�F '��K�pp'�j�r.x �tix, �I(��1 SS(Z .52,s'- (� L�,t �oZ- Nft.t�rvc�.Au� n 32 51S"oa <br /> 'J''r1V111L4 � lV�, ,I�SA�JV' l�'JLi.JY �C'�C1LI1 (�Jl� Z'9JZU � _�S�_(�� S�fATELICENSE/ <br /> U'VIhNILAlCO�.'fR�G IMILnDORE55 CITv IIP PHOHE ST�TELICENSE� <br /> ClUM01NGPJNiRACTOR MnILADDRE55 GRY ZIP PMONE 5T0.iEUCENSE• <br /> �.f.'�iHaGTPR10E DF <br /> <� Oro <br /> ' '.�uo�y+OFK AND 5011APE FOOiAGE INVOLVED TA T PERSON PNO�IE�10 <br /> �',.. r � � -� -�s�v � ���=�oc`i <br /> I(r 1_i?,N l II'111�V <br /> i HEREBV CERT�FV THAT I HAVE READ AND E%AMINED THiS <br /> ,a�-r�oreseo use oF ewi.uiNc APPLICATION AfJO KNOW THE SAME TO BE TRl1E ANO CORRECT. AU_ <br /> Jp�_S TAUC�Nf v'I aDA-�)i 1.�G PRGVISIONS OF LpWS AND ORDINANCES GOVEflNING THIS TYPE CF <br /> i��;���.oescaivrioe�ocvaovearriar�ovmee�owoantTACNtwocoPiEs� WORK WILL BE COMPLETED WITH WHETHER SFEqFlED HEREW GH <br /> f � '2 ,�' / `7 � �I% NOT. THE GRANTING OF A P[RMIT DOES IJOT PqESUME TO GPd6 <br /> i°� BiOCK"YO(D—� o� AUTHORITY TO VIOLATE OR CANCEL iHE PROVISIONS OF ANv <br /> OTHER STATE dR LOCAL LAW REGULATING CONSTRUCTION OR THE�. <br /> �- p,�. PERFORA7ANCL OF CONSTRUCTION.THAT I Ald AUTHORIZED BV iHk: <br /> 1�� "^�,� ,=� OWNER OF T IS PROPERTV TO PERF Rld THE WORK FOR WHiCL <br /> ^'� APPL�ATI IS MADE �AND 1 OMPLY WITH THE STf,if. <br /> rn .i.i tax i o.rvuMeEa �� � C9id? F CT . S LAW 18.27 RC AN 296200 WAC. <br /> �� . _ � - 60U � '�� v �a <br /> CO��S*RUCTIONLOANIENDER.ADDRE55,TEL[PMOI(ENOMBER / � � . � � ' �{"��� <br /> ]�-.__.,- 1.�.__'J l�" Z � -_ <br /> PFOJECT ADDFESS Pj p U I " �'L l" J U — --- `i�` . I _ �� ��F��- � <br /> /U�� J I � .,.—y =��i�� � y_ <br /> PWMBING MECNANICAL� �\ <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> l'JATEA CLOSET ITOILf_T) A C—A�HNDLG UN17S—H P. <br /> BATHTUB FOPCED AIR SYSTGIdS—B.T.U. fd E.A. <br /> LAVATORV(WASH BASIN) UNIT HEATERS--B l.U. M <br /> SHOWEH CLOTHESDRYEFS <br /> KITCHEN SINK 6 DISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER WOODSTOVE <br /> URINAL fdE7AL FIREPLACE(WOOD BURNING) <br /> DRINKING POUNTAlN I FIREPLACE INSERT <br /> FLOOR DflAIN HEAT PUMP <br /> �ACKFLOW PREVENTERS GAS PIPING <br /> ROOF DFAINS—R�INLEADERS EXHAUST FAN <br /> SINK�SERVICE—BAR.ETC.) <br /> _ i <br /> -- � <br /> SUB TOTAL 5 SUB TOTAL S ' <br /> PERMIT 5 —� PERMIT S � <br /> TOTALFEE $ TOTALFEE 5 <br /> FOR OFFICE USE ONLY: <br /> fP0'ligfl�inLh qERRSE�B�CN SIpEEETBACK PI_qqCH[CN1lil!"F6H f[E �[(�CIP11Jj1�� <br /> J�). �L� � f . <br /> u;,�„ouc �otanEn vncnr+re��rE FEES VALUATION FEE <br /> �- VES .'7 NO ew�DirvG �L 1 l� '� �1F7 � �_�G <br /> i <br /> 1'�a10�GON5i NOOFSTORIES ecnr��r ;so�tmEwnuuwis �— - <br /> .�rtAl , "�' g PWM0ING _ <br /> .YIV <br /> hIZEOfOLW FlRESPR�NKL[HSPfO'D BFSEMENi MECNANICAL <br /> �4 73 � �i. !uo L, YES k NO _ 1 <br /> orair�nmcv�onv Flae nunM neo o unGN�nvirnnorv ADDI7tONAL PUN GHECK �L ;�/� <br /> � �� _ OTHEfl <br /> , .. ,-.�IJ � <br /> sTni c ow�oimc suncHnace (�L� <br /> , :.����rr rinm;n���a��v�oev � CITYOFEVCR[TT puoi.icwoaKs / <br /> �M I LOCAL SALES — ��7 rr , <br /> �,�,F z �, tf . TAX CODE IS 3105 iorn� � <br />