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APPLICATIG 1 FOR CONSTRUCT_�N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SVSTEM: I 1 GAS U ELECiRIC 'i[Q�IFi l <br /> BUILDING DEPARTMENT �— <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> owr+cn wwr,00nFst��/�/�YR/LticMW�' OR. �m vr�oNc <br /> �`26 .on+i, r�zc C3�'i/Nni�ivc_N.on.9.,.�',.6�c ( ,�vA-.�"/2� <br /> iENANt M�t�ODFRS CIIY IIP CNCNE <br /> ARCN�1[C�q10E5i6NEF N�M1AODFCSS ���� I�P P�a'F <br /> GEHERTLCON1P�CiW M�.L�DD�f55 CiiY 2�P PIIGNI S�iCLiCCNSE• <br /> v,�.v,2.��Ca��� r�•c—�V���n" 9820�.�3�9-i'i08 v9NRotSi2/�v/c <br /> uECN.xr.uca++u�c*on M�a�ooncss cin xi+ r��owc s*�i�iKcr�sc. <br /> rwuoivcca+m�c*on uuinooness cirv z�r r��ovc s�*iuccxsc. <br /> C1A55 pF NpI1M <br /> NEW ADUITION TERAi10N )CREPAIR J�OEMOLITION WOODSTOV6FNPLWSERT BWLDINGRELOCAiION <br /> 1 1 m7 �)`�/• corvtl.trvcnSpNANUMUUENo <br /> / (G' <br /> cornn�crrwct � x _�vfObO.tlO 1E1JN ✓AN.�S��EK -��� _ — . <br /> o�sca�nrwoaK�r�osaur.acroo��c�iHvrnv�o ,s-zq 54.F7: <br /> o_Fq������,sr.y�� cn�cfc' y10$' <br /> aaoros[ousEa omim�+a I NEREBV CEr7TIFY THAT I HAVE FEAD ANO E%AMIt1ED TMIS <br /> Gj���R�. APPLICATION AND KIlOW TMF.SAME TO BE TFIIE AN�CORRECT.ALL <br /> im��oEscmr�rorvosrnor�nrvrsr�am+ouowone*rr:�aaunccrrts P�70VISIONSOFLAWSANDORDINANCESGOVERNINGTNI57VPEOF <br /> WORK WILI BE C01d?LETED WI1H WHETMEN SPECIFIED lIEREIN OR <br /> io*�_ e�ocK c. NOT THE GRANTING OF A PERAl1T�OES NOT PR[SUME i0,IVE <br /> AUTHOflITV TO VIOLAiE OF CANCEI 1ME PROVISIONS OF ANV <br /> �OTi?/.��1J,1O•11Ca4KOQ/�/nv'yT�rY���f OTHER STATE OR LOCAL LAW REGULATING CONSifll1CT10N OR TME <br /> PERPORMANCE OF CONSTBUCTION.THAi I AM AUTMORIZED�V THE <br /> /lE/bL/JT OF1Q.�_(/�Y.OIZ M��PSF/VFrtL/l13L�!yjS/C OLVNER OF THIS PROPERTV TO PERFURM THE WORK FCf�WNIGH <br /> r�, APPLIC�TION IS MADE AND I CO�APLV WITH TME STATE <br /> CONTRFCTOF$L�W 1827 RGW AND 29G200 W�C. <br /> �/Q 2 ys oEi F3R��nEt�i,v✓a�aClE1L <br /> / <br /> OFLYAXY��l�R_K_i3flT�LO_F_J'NALN�117fJ_CatiN �J Q7�/�l�T_�-�L�-9�ti <br /> anaEci�noncs, WilJSN�NO7D.v <br /> y�i <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TUflE Ofl ITEM FEE NO. TYPE OF EOl11PMENT FEE <br /> WATER CLOSET(TOILET) A C—A HNO�G UNIT$—M P. � <br /> BATMTUB FORCE�AIFSVSiEMS—BTU. ME.A. <br /> LAVATORY�WASMBASIN� UNITHEATEPS—�.T.U. M <br /> SHOWEII CLOTNES DRYERS <br /> RITCHEN SINN 8 DISP VENTILATION FAN ' <br /> —� _ <br /> OISHNASMER RANGE HOOD <br /> LAUNORV TpAV WATEF 4/EATER <br /> CLOTHBS WASHER WOOD SiOVE <br /> URIN�L AIEiAL FIP,EPLACE 8 CHIMNEV <br /> OPINNING FOUNTAIN FIFEPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACNFLOW PREVEIITERS GAS PIPING <br /> ROOF DRAINS—RAWLEADERS E%HAUST FAN __ <br /> SINN�SERVICE—BAR.ETG) — <br /> SUOTOTAL $ SUBiOTAL S _ y_ <br /> PEPMIT S PERMIT b <br /> TOTALFEE 5 TOTALFEE 5 <br /> FOR OFFICE USE ONLY: <br /> FPONtS[1BGLN PE�PSRA�OIX SIpES[iB,CN PLYIC�C�NUAnOIR/ ff!-7 � n✓ �C[E`'�o1N�� <br /> Zp � O 5 3S / � 7 <br /> uscza+t o*e'nen�-�T v�crHisirt FEES VALUATON F/E�E <br /> �� ''J'V N� 9UilDING gtL}.�t� f(�/�� —" <br /> IYRq[ONi5�1aNA4lF IVi`f01WN51K1W1 M4��4 um�1d'.v':i�"` <br /> TI u '/r ,� '''�j0 � PWMBMG - <br /> S¢fOiB�pG NDOPSipR�6 0A5[u[u{t/ MECIIANICAL <br /> OC�crts finESPPrvxLEPSRCOD ��EiGNiUMOOiON RDOITIONALPUNCHECN <br /> ♦ <br /> �Q SPIiINFLEH <br /> NCA'vql LOfl SPRiNKlCPS <br /> STATEOUiIDINGSUPCHMGE � � � <br /> �r�uncev nnvsevoaweoev CITYOFEVERE7T puoucw0arc5 <br /> LOCAL S11LES - <br /> J�� 1 �G 3 TIIXCODEIS3105 TaT�� �/ ,�jC <br />