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Cp�[o��pr�an A "-�P�.i CAT i O N �O�. ���«�� <br /> LONSTRUCTIQN 0 <br /> everctt PERMIT <br /> �UILDI�•1G DEPARTM[WT TO 8E COMPLE7ED IN INK- PLEASE PRINT <br /> 259�8745 <br /> O DEMOLITI6N ❑ COMBINATION �BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> wwxe <br /> y `� y r�ei�nooness �/ ���' n zin � <br /> ���'''''' or���rn I�kev�e�v G+-�ve fllr IC�� �yrj qQ033 8Z7-7�'�J�' \��.��1 <br /> � � `y Noil�Yk (n itnl InveslmEn�S 5�7Zq <br /> rani�noon[5s cirv z�r r'nonE ,.,� '�� •,� , <br /> /��uuIrzcrono[swr�cn hd I. nnivva( Iva `]8o3s -778 -��0 �u�''..1� � ��. <br /> � yy �-IYL`11�ECI5 �C6i It CYCU ZO���i CJZ_ �VC�1�• cirv xir r��or�e LICCNSE• , <br /> 4DiE"^L CONiMUOn `I .{ <br /> M��tnn nEss �'�\� <br /> � �j•�--.�J�1 IVOI SC�eCff cim zir o e icc e � <br /> �dti�a- rnna�ooness ��`�' <br /> H ~ Mco�+��o�toranetion <br /> "�+J H K0.1 N�� �IGCTEP em zm rno�ie i�co�s�. . <br /> VJ H <br /> viw�eiNacornn�cwn i.ni�nooncsr, <br /> xz �JoT StL�ctC-D <br /> [x7 O � i.5,or wa�K <br /> Q H d ,�NEW L �DD�TION ❑ �LTERAIION ❑ REPAIR ❑ UEMOUTION ❑ N'OOOSTOVEiFRPLINSERT ❑ BUILOING RELOC�11011 <br /> ".tlOC7 veiw�io��o�wanrcicos�onan�cnmisrtusuoon� <br /> H r� o JC '1.5—+tii������ �lo�lurs �-�( C<, � , 'v <br /> c�� 0 1 <br /> r <br /> r� o�scnmcwann ` j�-r <br /> � y z (.f��ruc��on � a 200 �n,;!- aparkn��ti-� fOni e� '� ,, <br /> H y use ov eunon+c I HEREBY CERTIFY THAT I HAVE f7[AD AND EXAMINED TtiIS AF <br /> tyy OeSil.�1l_UI C�{L�hl������s) _ PLICA710NANDKNOWTHESAMETOBETRUEANOCOPREC7.�LL <br /> O H I\ (Al� ll C^ <br /> ('� C5yC/� icc��ocscmruo��orrnoremri,r�owriouo�4'oneiucrirouncorres OFWORKOWILOLBE OMPLET�EDWI I-NW'{EG'OEFiSPECFIEDHERE� <br /> � `" � ioi_oioc�—or INORNOT.THEGRAN(INGOFAPERh11T�0ESNOTPRESUMElO <br /> / / I GIVF. AUTH�RITY TO VIOLATE OR CANCEL THE .'ROVISIONS OF <br /> NO (/� „��,/° �� �1�1'�17�.(r /1G�n� ANYOiHERSTATEOflLOCALLAWREGULATINGCONSiRUCTION <br /> OR THE PERFOHMANCE OF CONSTRUCTION. <br /> � sicNnroneoFcornnncro�onnumonizeoncn+r onie <br /> X P�jn, , �CU� 5 I 5/g7 _ <br /> pr pucnrvrs cirv nusn+ess ucer+se rvo. <br /> v00JECt�0UPE55 � � r � <br /> �U r-a(G, (lP ,:.n �s .:_i j(:i�: �:) <br /> � � MECH4NICAl <br /> PLUM�ING TYPEOFEOUIPMENT FEE <br /> TYPE OF FI%TURE FEE NO. <br /> N0. —_ �-� Alfl CO�lD.UNIiS—N,P.EA. <br /> y� WnTERCLOSEi�TOILGA ----�-°' � AEPRIGEf1AilONUNITS—H.P.EA <br /> BATIIiU� <br /> / OOILERS—HP.EA — <br /> �pyATO(1Y�WA511 BASIN� —-- <br /> G�5 FIRED AG UNI75—TONNAGE EA __ <br /> SHOK'En — <br /> FOPCED AIR SYSTEMS—B.T.U. M EA. <br /> y KITC�/ENSINKBDISP. ---- <br /> ���ri� W�LL IIEATERS—O.T.U. M <br /> _�. DISHW�SHF.❑ UNITHEAiE�S—�.T.U. M <br /> �r�A LAU�»�YTRAY <br /> ' _�Zi GLO7HE5\YAS��ER EVAPOfiATIVECOOLERS — <br /> � � 'Z. CLOTHESDFYERS �� <br /> WA1ER HEAIER VENTILATION FAN — �`/� <br /> I ����'� U�IN�L _� ppNGE HOOD <br /> , .r w� ORUIRING FOUNipIN _ __ <br /> pIR INNDLING UNI7— CF.h1. <br /> , , FlOOf10nNN STOVE -- <br /> ' yprppl.l�fiEAHERS �� �,�EIAL FIREPL�CE 6 CIIIMNEV <br /> � ROOF Df1AINS—fi41NLG�EPS <br /> WOOOSiOVE/FIREPL�GEINSEqi <br /> I SINK ISERVICE—�AR,E1C. <br /> I + _�_ ___ <br /> 1 '�� . SUBTOTAL s — <br /> ��-' SUBTOTAL — pEPMIT s_ <br /> PERMIT S — 3 <br /> TOTALFEE <br /> TOT��FEE 3 <br /> � 1��� THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL _ <br /> ' r�u+c�rec r+urnaen runcnccrcree <br /> I rnomseioecK n[�nse�oncn sioese�oncK � /']�/-'(��t�, / C,r���S �ECEirr�+oG�^�� � <br /> lS� I ( � 1� fEEICt �7i) 1) Ii_Zrl <br /> USEI�NE LOtAIiE• y���ryI511E fEE4 V�lU�T100 fEE�� <br /> ���4� OYEGONO �j. 'U _ <br /> fYi'EO�CO��g�� OCCUPPIICVGI�OUP ��O.OfOW�I[LUNOUNIIS ' D <br /> � / �� �� / `�� 9UILOINO s <br /> s�z[oV^�i/�� r�oa:2 ni[ 3 uncocNAo �� . <br /> � PIUTApIN� CI! <br /> /4 <br /> M[CMAYIC4L � <br /> FIRE SPtiNKLERS PEOUIREO YES NO OT11Ef1 <br /> PENPLTY <br /> APP�I�AIIONFCCOY fL���5G1[CNEODY APP0.FOqIS511ANCE0Y — � (�(� '� � <br /> � /] TOTAL r lJ�l <br /> �� �C% <br /> Y <br />