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� APPLICATIt'� FOR CONSTRUCT � aN PERMIT ���� <br />, TO BE COMPLETE�IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: U GAS f]ELF.CTRIC ❑ , <br /> BUILDING DEPARTM�NT —� <br /> 259-8810 <br /> I I DEMOLITION I i COMBINATION I i BUILaING I i MECHANICAL i I PLUMBING �SIGN <br /> OWNE� _ _ MRILA�RE� I���.��QT� �S� ����� <br /> '�yY1�IaVl <br /> TENANT MpILADDflE55 CIIY ZIP PHONE <br /> N1l� <br /> A��CT�SIGNE�� �AIIAUDRE�S � CITV . ��Q� ��� PHONE +� <br /> N ti�i� v (�/1 <br /> � GENERRLCONTRACTON IL�DDP.ESS • CIIY IP PHONE SIATELIGENSE/ <br /> C�'�� �,o�w� I'115 l0O PL.Z�. �Ve� �l8?.Dg 338-Zt14- <br /> r�MECHANN.TLj'ON CTOR MAIL pqDRESS QTY ZIP PHONE SUTE UCENSE/ <br /> `l.iv \0���{� 0 l - .�� <br /> PLUMBINO CONTRACTOR M�IL RODRESS CIiY ZIP PHONE STATE LICENSE t <br /> CU SOFWORN <br /> NEW I I ADDITION I I ALTERATION I I REPAIR I I DEMOLiTION I I WOODSTOVE/FRPL INSERT I I BUILDhvu REICCATION <br /> 3�� __ CONTAC�SON AN N O (� 1 1 �—Q��w <br /> ai,o_ .,�n.:ou cj. <br /> CONTR�CT PRICE OF WORN VYv 1:N� I�.tc•1 V <br /> � DES�W ' (AND5011 qEFW AGE�OIVED_ ��r ��m <br /> YE'�C_Gi i��yji� <br /> raoPO�USEOFBUR0ING —�—� I HEREBY CEflTIFV THAT I HAVE READ AND EXAMINED THIS <br /> /l1 '_ <br /> � J���� APPLICAT�ON AND KNOW THE SAME TO BE TflUE AND CORRECT.ALL <br /> LEGALDESCRIPTIONOFPROPERTY�SHOWNBELOWURATTr1CHFOl�NCOPIES� PRQVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or e�ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> G ������ "1 '�I OTHER 3TATE OR LOCAL L W REGUTATING CONSTRUCOT ON OR THE <br /> � PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> � APPLICATION IS '.�fADE AND I COMPIY WITH THE STATE <br /> CONTRACTORS LAW 18.27 HCW AND 296.2001NAC. <br /> x ��° '� Z <br /> PHQIECT AODRE55 VJ 5!f•NARIDE oe�E <br /> O�D� �� •��� .� V LIIVBUSMESSLMENSENO , <br /> PLUMBINQ MECHANICAL <br /> NO. TYPE QF PI%TURE OR ITEM FEE N0. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—H.P. � <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) � UNIT HEATEFS—B.T.U. M ; <br /> T <br /> SHOWEF � CLOTHES DRYERS � <br /> � KITCHEN SINK 8 DSSP ; VENTILATION FAN ; <br /> � DISHWASHER � RANGE HOOD �— <br /> � LAUNDRV TRAY ; WATER HEATER ' <br /> CLOTHES WASHEfi � WOOD STOVE � <br /> � T <br /> URINAL ; METAL FIREPLACE 8 CHIMNEY � . <br /> DFiINKING FOUNTAIN • � PIREPLACE INSERT ; <br /> fLOOFi DRAIN � HEAT PUMP �— <br /> � <br /> BACKFLOW PREVENTERS ; GAS PIPING ; <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) ; ' <br /> — <br /> i � <br /> i � <br /> i — - ; <br /> � <br /> � � � <br /> SUB TOTAL $ ; SUB TOTAL S ' <br /> PERMIT $ � PERMIT $ � <br /> � <br /> TOTALFEE $ ; TOTALFEE $ � <br /> FOR OFFICE USE ONLY: <br /> FFONT E 6 Y, RER ET CK SIOESETBAC PLANCHECKNUMBER i FEE NECEIPTNO. <br /> o' � ►o� 373 <br /> USE 20NE LOi A EA VACANT S e FEES VALUATION FEE <br /> SZ� N � N � BUILDING Q pp� /�-- i — <br /> IYPEOfCONi ILOWABLE TYPEOF �CiOAL aara .r HOarttN uufuNiiS -�- <br /> N �° �, � PLUMBING � <br /> SIZEOFBLD No.q $7�5 eA MENr MECHANICAL � <br /> Npr N Npo , <br /> OCCUP.4 CY AD PIRE 5 RNKL/yRS REO'0 HEIGH7lIM17 ION 'J ADDITIONAL PLAN CHECK j <br /> � ^ �/'� ' " • ` �"� T SPRINKLER � <br /> flEAS ORSPRINKLER4 — T <br /> STATE BUILOING SURCHARGE � � <br /> INTPNE9Y PLANSAPPPOVEDBV CITYOFEYERETi PUBLICWORKS � <br /> LOCAL SALES � <br /> 1 Z3 9� c) TAX CODE IS 3105 Tota� � S� <br />