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APPLICATIS'V FOR CONST�UCT"7N PERMIT �✓� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> l HEA7ING SYSTEM: ,k{GAS J EiECTRIC J _ _._ ____J <br /> BUILDWG DEPARTM'tNT — — <br /> 259-e810 <br /> DEIdOLITION COM9INATION _ _ BUILDING XIdECHANICAL PLUMBING SIGN <br /> .—_ — :,r» — . -- <br /> CA_P1_A�41�c—_('4�3 Nr�YIAr� E�E��r 3d'2o i �8�c-�-- — <br /> I��.A��l MIRMOPCS: C'IV a�� ��✓Jf.0 <br /> ..��_-1{CI6�11':-�✓:4iv 4'iL��ORC�S Gtlr T.p 1`�V.N:f <br /> G-In[naLCVi1PeCILn 1I<.L�CJ��6S Oiv j,r rrw.rp _�clLiCliP,E• <br /> u.�Ln1�rCRCM1�eeLIDe w4eLL4lSS CPv N CiC 51n�ELiCLNct� <br /> E(�Pt��GN_tC�l,f�_2121!S(��v.�,1 PJJ D,V �OLo_— J)J''Oj��L��/��1[rJ_,tN— <br /> rwveemmv�R.cre9 uui�nun[ss cnr nv o.�a�e •.+��ru•rv;e. <br /> con:iuc�vn�.t a wonK --'— <br /> �-�`f'�O OO -- — <br /> .. ._ _[v.V�e nqu sa4nr r OGieeE nnavm epNUet rFnSpx u�D PnONE xo <br /> �hl�l��1�� -�^�7�a-�e�...Q _ -.— <br /> W"'"'��� L-A�K��—._ I HERE�V CF.fliIFV THAT : HAVE FEAD AND E%AMINE� iHl': <br /> =�>.��'�'r������;�*'^� FPPLICATION AND NNOW THE SAAIE TO dE TPUE ANU GORRECT A�L <br /> PROVIS�CNS CF LAWS AND OFDINANCES GOvERNING THB TVPE OF <br /> �,i,,,�; �;, -er:o��°norr.�n.�.�.:;o��e.o:�e�mrnor.woeorrzs, WOFN WILL BE GOMPLETED WIiH YlIIETMEF SPECIFlED MEREIN OR <br /> . e«rc .« _ NOT THE GFANTING OF A PERMIT DOES NOT PRESl1ME TO GNE <br /> — AUTHORRV TO VIOIATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCFL L�W REGULATING CONSTRIIGTION OR TNE <br /> � -- PEPFOFldANCE OF CONSTRIICTION.TNP.T I Ah1 AUiMORl2[D�Y iNE <br /> OY/NER OF TIUS PROPfRTV TO PERFOPId THE\VORK FOH WNICH <br /> APPLICATION IS I.:AD[ ANf] I CCldPLV \'JITH iMC: STAT[ <br /> �;nri.i ua i o r�uun[n CONTRACTORS�AIV t8 2�RG1'I.VJ�29f?00\'JAC <br /> � . � . .-��u�� . ,n,�aoen J /, <br /> - _— -- x—J4__v�J.— __ lo • 7_93 _ _ <br /> GROJECT AOOR[55 -"��� '�' <br /> ���z rlvvT adE — - ------ --- <br /> PLUMBING ��ECMANILAI <br /> IlO. TYPE OF FI%T�RE OR ITEM FEE NO TYPE OF EOUIPMENT FEE <br /> Vi�TER CLOSET IiOILET� A C-A MNDLG UNIiS-H A <br /> _ �4iMN9 _ � FORGE�AIqSY5TEM5-BTA. Id EA <br /> LAVqTORY�WASHOFSINI UNITHEFTERS-BTA. M <br /> Si101YER GLOiNLS DRYERS <br /> KITGHENSINKBDISP ' VEYiILATIONFAN ' <br /> DISHWASHEF FARGE HOOD � <br /> LAUN�RYTRFV ' � WATfR MEATER <br /> CLOTHES WASHER WOOD S7OVE ' <br /> URINAL ' MFTALPIREPLACEIWOODDURNING) ' <br /> DFINNING FOUNTqM FIFEPLACE INSERT ' <br /> FLOOR ORAIN HEAT PUMP <br /> B�CNFLOWPREVE�lTERS ' GASPIPING • <br /> ROOF DRAINS-HAVJLEAOERS E%HAUST FAN � <br /> SINh�SERVIGE-BAR.ETC.� ; <br /> SUB TOTAI S SUB TOTAL 5 Q _� <br /> _ __ PERMIT S �— PERMIT 5 _��`�_� <br /> TOTALFEE 5 — _— iOiALFEE 5 �n`' �' <br /> FOR OFFICE USE ONLY: <br /> �.,.�=,i•irnitc nrnns�mne. smesironen ruxermK �vet � ie� !�orrno <br /> i <br /> a��s <br /> ,. ,��mr �.mrpc� vecu�tsn[ FEES VALUATION F"E <br /> � VES � � NO gWLnING � <br /> ��'[NCCN51 MOCi6IDqiE5 Cronw.r .v.iun.��t - ' , <br /> e+cv FIllAA9iNG ' <br /> �-ica�BLOO viqESanrcMlEn5PE00 MSEUExi MECNANILAL I�s� � <br /> '"' VES -. NO — — - - . <br /> ���"VPWCYIOM FlqFKNWPE00 MPG��1UAalnlidN R�OIiIONALPLwNC�iECN '. <br /> _ ._ _. . . _ OiHER �� .� � <br /> n.->ItM _ _—_ _ . . <br /> SiAt[DUIIDiNG SpRGMdP aE ' <br /> :..cer a��.:����-�*���:�i�� GTYOFEVEflEiT vueucwoaKs � � <br /> � I LOCAL SALES — — <br /> TA%CO�C IS 3105 �o�A� <br />