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�S.�P�"LICATION FO� ���,�„ <br /> '^•EY•IO'Nn CONSTRIJCTION <br /> ��r oF e <br /> eve�ett PERMIT <br /> BUILDING DEPARTMENT <br /> 259-8745 TO BE COhiPLETED IN INK• PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION Cl BUILDING ❑ MECHANICAL ❑ PLUPABING ❑ SIGN <br /> aW���n MAlLR009E55 cin �iN ruor+e <br /> SLASU Mc.l ��cj I olZl �u�leC�le�r,Uw�� �u�f2-�rT ���.o � .3t-.�— s�/�,c/ <br /> •RCIIIIECIO�OFSIQNER M�IL�DpREuS CITY 21P PIIUNE <br /> GENEML CONtMCIOR M�IL AODRESS CIiY ZIP PMONE LICENSE• <br /> MEC�IRNIC.1l COy1MQOq � M�ILAUOfiESS . CRY 21P PIIONE LICENSF •i <br /> —;ra� 'r �e�5��-a,�o�, �l-f�B' �/. ,�n��v d�i,� /��c/4i�lb r �'8��� ��J-3�J- sc,�•'., <br /> PLUMBiNUCON10AClOf1 M�RAOO�ESS CIIY 21P PIIOlIC l�p����� <br /> C1�550r WOBN <br /> C] NEW �I ADDITION ❑ ALTERATION ❑ REPAIR ❑ OEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCA710N <br /> ��lUAiION OF WOPN�COSf O�MALERIRLS PWS L�BOAI <br /> SCo �� <br /> DESCf1iBE WORN GfJf�7R�� ��f y lt/�� -�y l�'!�/o w G✓�� B.�.sn.Z2 /nt•N� ,.(/1F��/1hw�'�, <br /> / a ' . ne � � , t - / + a.t. aN. ' - _ <br /> U55 GI BWIDING <br /> � <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THI� AP• <br /> .;�Q'� PLICATfON AND KNOW THE SAMETO BETRUEAND COAREC�f.ALL <br /> iFee�oescmrnor+ornaoreiar�siwwNeciowonnn�curouncoaies PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTti'PE <br /> OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED H�RE� <br /> LOI_BLnCK_OF IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANYGTHER STATE OR LOCAL LAW AEGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF C(:NSTRUCTION. �/� �� <br /> SIGNATUREOFCONiPACTORORAUiHOPIZEOAGENi �A7E <br /> X G�/U Gu �"iC�' c�acr <br /> rnn�rr.reonnrss nrrucnHrs mnu;inrssur.ru.cTi+n <br /> �c%/ �U�/�C�r��/ r,�� y- r��r��� �" o <br /> PLUMBING MECHA171CAL _ _ <br /> NO. TVPE OF FI%TUIiE FEE NO. T1'PE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILEI? AIR COND.UNITS-H.P.EA. <br /> BATHTUB REFRIGI.RATIOII UNITS-H.P.EA. �'� (� <br /> LAVATORY�WASH BASIN� OOILERS-H.P.EA. <br /> SHOWEH GAS FIREO AC.UNITS-iONNAGE EA <br /> KITCHEN SIN!(8 OISP. FORCED AIR SVSTEMS-B.T.U. M EA. <br /> DISHWASHER �NALL HEATEFS-B.T.U. M <br /> LAUNDRYTRAV UN17HEATEF75-B.T.U. M <br /> CLCITHES WASIIER EVAPORATIVE COOLERS _ <br /> WATER HEATER CLOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN F7AMGE HOOD <br /> FLOOR ORAIN AIR HANDLING UNIT- C.F.M. <br /> VACUUAIBREAKERS STOVE <br /> ROOF ORAINS-RAINLEADEFS METAL FIREPLACE 8 CHIMNEV <br /> SINK�SERVICE-BAR.ETC. WOODSTOVE/FIREPLACE INSERT _ <br /> ¢ p vfne � — – ` – — <br /> SUB TOTAL 'U SUB TOTAL 5 __�� <br /> PERMIT 3 PERMIT S G'G <br /> TOTAL FEE S TOTAL FEE 5 1{/� <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> lIIONISEIBRGK f1[a05EfOFCN $IDESEIBRCK PLANCMECNNUMOEfi PUNCIIECNfEE <br /> FEE �EC,IPi NO. <br /> USE20NE LOIMEA yqCRNi51iE <br /> FEES VALUATION �CE <br /> OYES ONO <br /> IYVEOLCON51. OCCU�'ANCYGfiOUP NO.OFDWELLINOl1NIT5 <br /> OUILDING S <br /> SiIC O�OLOG NOAf SiORIES MFK OCG.LOn� — <br /> PLUMBING 5 �� <br /> —_ MECNANICAL '� �_�� <br /> FIRE SPRINKLERS FiE0Ud1ED ❑ YES O NO <br /> OTHER <br /> PENALTY <br /> APVIICAIIONRLC.dY PLANSGHELNEDOY /PPR.FOflI55UANCE81 '-- <br /> �� � ' � � TOTAL �� Qr/ <br />