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APPLICATIC J FOR CONSTR�ICT )N PERMIT �r <br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT .. e�r�k'r <br /> BLILDING DFPARTMENT HEF7iNG SYSTE_:- J GAS J ELECTRIC J_ __.____ I <br /> 259-8810 <br /> � OEMOLtTION � COMBINATION BUILDING . MECHANICAL I. PLUMBING SIGN <br /> ovnrvea ou�eoo�ss —c*r i,�. vHa�e <br /> ��{�H�C. Tt.iJc 1viR il_-ir 4 / r7/- 957�i Z>$_GS/y <br /> i[r+uir w��a�oA[ss �irv na — pr�prt <br /> t.+'.�'.'�C1CqpE$IGN[P YRpAppPE55 CRY 2tP YNJNE <br /> •. i �«CON�HACIDq I.YILAOOPE55 CRY IIP PXONE 9REL9EIISE� <br /> 4ECHNu1f,ALCqitP�Cidi WL/.fq�E55 CILY YP CpryE S1I.iEL�KCHIISE� <br /> ;�"3'viE�J /�97�✓/, i„cz './Es-o � �'& c'iJ� QiBzc�; 353-33Y/ .:c�IJic�y'��Y9oc.. <br /> ��,�.m��ccartn�cion u�n�on[s� rn zrv vnp�e s*+�t�Kcr�scr <br /> .��4CIPN4EW WONK <br /> /C(.Y� <br /> ' ��E�wMNANpSq/�qcp�IAGEXA'RVEO [p�i�CTPEi15CMM10PNG+EIq <br /> I HEFEBV CERTIFV THAT I HRVE PEAD AND F.%AMIN[D TMIS <br /> �. �o�.EniseoI�/euuonm qPPLICATIGNANDNNOW7HESAMETOBETRIIEANDGOFRECTALL <br /> __ '>in y�!-F Fq/�9i<</ PROVISIONS OF LpWS AND ORDINANCES GOVGiiNING THIS TVPE OF <br /> ,. ..�,i¢sF.vinHorvaorenni unavoeertecHiwocw¢s WORK WILL BE COMPLETED WITH WHETHER SPECI�IED MEREIN OR <br /> � __ �� � N0T THE GRANTING OF A PERMIT DOES NOT PPESUME TO GIVE <br /> Al1TMORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OiHEq STATE OR LOCAL LAW REGULATMG CONSTRUCTION OR 1 HE <br /> � PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER pF THIS PROPER'.V TO PERFORM THE WORK FOR WHICM <br /> ' - APPLICATION IS MADE AND I COIdPLV WI1H THE STATE <br /> �����.���x��NV4pFa CONTRqCTORSLAWiB27RCWAN�2Wi200WAC. <br /> �I37o -4 Z(e-o Z3 -.�o0 5/ <br /> CO'li*RVGIipxLO^NLV1R.11 LOCRESS.tELEPIbNEM1YBFfl / I <br /> r ��� <br /> PFOJECT AD�NE55 -- �T <br /> ZcIP� F(�x ' <br /> PLUMBING �,�ELHANICAL� <br /> N0. TYPE OF FIl(TURE OR IiEM FEE N0. TYPE OF Eqt11PMENT FEE <br /> YlATER CLGSET�TOILET� A G-A MNDLG UNITS-H P <br /> ��T�T��� ' I FOFCEDA!RSYSTEMS-BT.LL M EA. � <br /> _ LMATORYIP/ASHBPSIW ' IINIiMEATER$-B.T.U. M <br /> SNOWFR CLOTHES DRYERS <br /> NITCNLN SINK d DISP VEN71LA71pN FAN <br /> �ISHW.tSHER qANGE NOO� <br /> LAIINDRY TRAV WATER NEATER <br /> CLOTHES WA541ER WOOD STOVE <br /> UR!N4L IdETAL FIREPLACE(WOODBURNING) <br /> _ DRINKINGFOUNTAIN FIREPLACEINSERi <br /> FIOOR D2AIN HEAT PCMP <br /> BAGNFLOW PFEVENTiqS GqS PIPING <br /> ROOF DRAINS--RAINLEADERS EXHAUST FAN —r <br /> SINH(SERVIG[-BAR,ETG) <br /> --- T <br /> __ Sl18TOTAL 5 SUBTOiAL 5 - <br /> _ _'_ PERMIT $ PERMIT E //� I <br /> TUTALFEE b TOTALFEE 5 <br /> FOR OFFICE USE ONLY: <br /> 4nONISEIOnC+ BfLF5E1H�CR 6iDE$FIBACR nlsqLnLIX1:p4P[II fCL PCC[Nflq <br /> _ � / � <br /> us[Tont m*a�.n vn�µrv*F FEES VqLUAT10N FEE <br /> .��� YES f. NO �ii�i�DibG <br /> I�M p CCM51 NO Oi 6i0PK5 Gu:nvtv :A b m�e,v..•.., . __ _ <br /> �•��o VLUAIBING <br /> silEOF&ll0 finESPpMxIENSnF6� B�SEu[vi MWIIANIUI ' <br /> ❑ YES ^� NO _' <br /> IXLUVNICYLWO FIREAlA114qE0U 4CIGMl�Mi1�➢Ory A�OIiIONALPUNLNECN <br /> OTH[R • <br /> nUSON _ <br /> STALE 11WL�I4G SUtiCNAPGE � <br /> MIMLIIv RGNSAPPNU(UOr CITYOFEVENETT PppLICWORNS � <br /> LOCALSAIES <br /> n.+c � TAR COOE IS 3105 TOiPL <br />