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APPLICATIO� FOR CONSTRUCT�N PERMIT � <br /> TO BE COMPLETED IN BLACK INK�LEASE PRINT <br /> BUILDING DEPARTMENT HEATING SVS7EM: ❑GAS U ELEC7RiC 7 � <br /> 259�8810 <br /> DEMOLITION ` '� COMBINATION I �� BUILDING I i MECHANICAL f I PLUMBING I ! SIGN <br /> oµa�n waeooncss cnv riv vuw�e <br /> hcel. -.iF�_=r�1 coinma�c�a�Y�e Ev�>e-[C 98zo3 3�n �5��2. <br /> iniwr uu�eonaess ci*v z�n rraec <br /> MCUI1ECiORO(SH'iqE11 YAiIAODRE55 GIfV bP FIKKIE <br /> LENFMLCIXIfPACiOR MAM1�OOP[SS CItV IIP P11011C SiA(ELCENSE• <br /> �4tG�c�,�.nrS 1z3z� V4N.j9Q5"Rb ��r.e� 9R2G�1 341-28�i l�htroo�tp�uPE. <br /> vrc���r.k��cartnncion u�n�on[ss cirv nv n�auc s+�rcik[Hs[. <br /> 1`tlll�p!NGCCNIMCIIXI Y�RM�RF55 LIiY ZIP Y�q11E Sl�1EIX[NSC• <br /> CO�!II�PALI Pf1iCE q YA11N t ` <br /> �C.l,-�4.�J���.\���E��',l�� <br /> �` .Cp�OEIWRn NOSOU�REiMt�GE�HVOIVW CANIICLCCRSONN.D('NIXI[NO <br /> 1�'.pi�Q�ur�ll ��alNhcn LL�-�1�A�:� <br /> Q�''_i�lrtxi� �m� ltw�p - <br /> '�- 1 MEREBV CERTIFV TMAT I HAVE READ AND EXAMINED THIS <br /> rnc nSEDus[a Buaou1a APp�ICATION AND KNOW THE SAME TO BE iRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS ANO ORDINANCES GOVERNING THIS TVPE OF <br /> �Er.uo[scamqr�pc>rovEn*ri9qwNBE�OwOn�rt�cHM(ICOr2s� WORK WILL BE COMPLETEO WITM WHETHER SPECIFlED MEREIN OR <br /> r �� a NO7 7HE GRAN7ING OF A PERlAIT�OES N0T PPESUME t0 GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE 00.LOCAL LA1Y REGULATING CONSTRUCTION OR THE <br /> - � PERFOflA�ANCE OFCONSTRUCTION.THAT I AM AUiMORIZEO BY THE <br /> OWNER OF TMIS PAOPERTV TO PERFORM THE WORN FOR WNICH <br /> APPLICATION IS �MADE AND I COMPLV WITH TME STATE <br /> �.ncu+e�i o Hauazn CONTFaCTORS LA1Y 1B 27 RC W ANO 296100 WAC. <br /> t't ! � - - OOJ � � <br /> Cp:SiRUCtKI1LWNl(NOEP/.OMCSS 1ElEPNp1CNUY0FP / , <br /> PROJECT 11DDRE55 x"'^G � °'� � S �� <br /> � :YC •'al � C. �3�`dtD'J <��.mrs.as,�ti�,.,�.� <br /> 7LUMBING ' MECHRNICRL <br /> NO. TVPE OF FI%TURE ON ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET�TOILET) A C—AHNDIG UNRS—HP. <br /> BATHTUB FOBCEDAIRSYSTEM$—flT.U. hl E.A. <br /> LAVATORV�WASMBASIN� UNITHEATEfiS—B.TU. M <br /> SHOWEfi CLOTHES DRVERS <br /> KITCHEN SINK 8�ISP VENTIlATiON FAN <br /> DISI/WASHER flANGE HOOD <br /> LAUNORV TRAY YlATER HEATEF <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE�WOOD BUflNING) <br /> URIYKING FOUNTAIN FIREPLACE INSERT <br /> F�OOR ORAIN NEAT PUMP <br /> BACRFLOW PREVEN7ERS GAS PIPING <br /> NOOF DRAINS—FAINLEA�ER$ E%MAUST FAN <br /> SP�K�SERVICE—BAR.ETCJ <br /> _ �� <br /> SUBTOTAL E SUBTOTAL S <br /> PERMIT 5 PERMIT S <br /> TOTALFEE 5 TOiALFEE f <br /> FOR OFFICE USE ONLY: <br /> iRW�iSEtfl�IX PUPSC�P4x SICESEiBACN PI.W�'N[ NU4PtB fEC PFCE�PiM <br /> ����I <br /> os�ra:e mru�cr MC�Ni5i1E FEES' V�LU�TON FEE <br /> .. VES � NO OWIDiNG �� <br /> Ic(qCOKI 1qCfstOFlEs �']oltiiuro.,.� <br /> "�''• pIUMBiNG <br /> .+�YCiBlCO i1R[SMN�tlEPSPEQU BAS[4EH1 1AECIUNIC/d <br /> �' YES . �. NO -- <br /> trCuvulGrlO�D OinENAnuPCOo I�EicN�li4i1�1qN �ODIIIONAIPUNWECK <br /> OiMER <br /> II�ASpI � <br /> STALE BUIL�ING SURGM4fiGE <br /> r�u.cm nu+s�rvnovEoar CITYOFEVFflETT w�eucwonrcs <br /> LOCIIL SALES <br /> o,�� TAX COOE IS 3105 rou� 1 � <br />