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APPLICATIQ 1 FOR CONSTRUCT�_ )N PERMIT � <br /> TO BE COMPLETED IN BLACK INK--PLEASE PRINT <br /> HEATING S"STEM: GAS O ELECTRIC ❑ <br /> BUILDING�EPARTMENT <br /> 259-8810 <br /> Il DEMOLITION I J COMBINATION I I BUILDING ;✓MECHANICAL ❑PLUMBING Ll SIGN <br /> ovmca u�M1�cwncss ci*v zir �»+E .706 ds3-83o3- <br /> �.,.x.c�.v J�qRBl3�'Y9e7'7 GtENc✓oo� A✓E Er�z�-rr 98an� <br /> t[NANi Y4lMt)11[55 Litt l�� PrqNE <br /> APLNRECfCACRC.NER M�LAUDRG55 LrtV ZIP PIqNE <br /> 175�-lI3/� <br /> GEM[nntcJNiR�cto9 MLLL�DOPE55 G�IY br eNp�F srR[IFENSE• <br /> _,Zp�_19..C..�y�jJTiN!9�A/.Q- lv�ai-�s�na Arr'r*l +°`i -levr✓s,� 9ac��6 _ <br /> AICCH�NCKCCN1F�Ci0� 4�K�OM�E55 LI1Y ZIP ���ONC SiLiFLKFNSE• <br /> -�`�7iLHH077T/� <br /> RLIMpiNGCM1R/.Cfql YAR�MNR55 COV ZIP ✓�ONE Si�IEIICCNSEi <br /> CG�L1��i p11iLE Cf WOt1N �,f`O Q <br /> r'.er.��.,e.✓ ��+y <br /> wv;nreEvmux�r�osau�n[roo*�cEmvaveo c�wr�c*r[n 'onro�td ��_� — <br /> �-83/y <br /> I NEflEBV CERTIFY THAT I IIAVE READ AND E%AMINED TNIS <br /> nnarouousca ouaowc APPLICATiON AND KNOW TME SAME TO BE 7RUE ANO CORRECT Al�. <br /> PROVi510NS OF LAWS AND OHDINANCES COVERNING TIi15 TYPE OF <br /> lEc�lceScrmrprvorvnrocnrvls�wwnBEiowone�*et�rnoco>iES� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOi PRESUME TO GIVE <br /> lo* - A�aK o� AUTHOr71TV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> — ?ERFORMANCE OP CONSTRUCTION.iHAT I AM AUTHORRED BV THE <br /> __�lo.r3.90�_0�=-�.33=QQ� AOPPL CATIONI ISRMA�ET A DPERCOMPLV WI�HKT ER STATE <br /> rnncc�uv i o Nuuocn CONTRACTORS LAW 1027 R:.W AND 296200 WF.C. <br /> CpIc1NUCIpN l WN IENDfP.M�N[S±.1FlFP1qNE NVMqFB <br /> a G woo .-�..'__kZ:�-L ii/ay/93 <br /> PROJECTAODRESS _ 5-01•""" pa�7�.s °"` <br /> �/'�' _ .�s.�eitiv w <br /> PLUMBING MECMANIC�L <br /> NO. TVPE OF FIXTUPE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET�TOILET) A�C—A MNDLG UNITS—MP <br /> B/TMTUB FORCEOAIRSVSTEMS—B.T.U. M EA. <br /> LAVATOPV�WASH DASIN) _ UNIT HEATERS—BT.U. M _ <br /> SNOWER CLOTMES�RVERS <br /> KITCHEN SINK 8 DISP VENTILNION FAN <br /> DISHWASHER RANGE HOOD <br /> LAIINDRV TRAY WATLR HEAiEN <br /> CLOiMES WASHER �YOOD STOVE <br /> URINAL METAL FIREPLACE(WOOD BURNING) <br /> URINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING ' <br /> ROOf ORAINS—RAINLEADERS <br /> EXHAUST FAN �— <br /> S:NK�SEAVICE—BAR.ETCJ <br /> — �— <br /> SUB TOTAL 5 SUB TOTAL S UL�I <br /> PERMIT E PERMIT E �j � <br /> TOTALFEE S TOT�IFEE S _ <br /> FOR OFFICE USE ONLY: J'� .._ <br /> IPONiSEip�LN PE�RREIB�GR y0E5EiBRLN PLAHO�ECMNUMBEP fCE 11ECCiniNO <br /> usrirnc iornnu v�c�Nrsrc FEES VALURTION FEE <br /> � "', VES �i NO <br /> ptlRDiNG <br /> MYIXfAY51 NOMST011[5 anr.r[. •�dwnii�ncirv��a — — <br /> �OP� al11MBING <br /> 5iI[pBlDO f1�E5PNWNL4P5PE00 P�SEMENt MECNANILRI <br /> -' YE$ ..1 WO <br /> OccuP/f�criWD Fmeeiem�n(OD NEnnt�.iwieibrv RDDRIDNALPLANCHEGK <br /> _ _ OTNER <br /> IICA504 —� <br /> S1ALE BNLDING SURGNARGE <br /> iniexenr MNSAPFNOVFOBv CITYOFEVEflETT puoucwoans <br /> �ace�saes <br /> o,,,E TA)I COOE IS 31D5 Tor�� <br />