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APPLICATI� FOR CONSTRUC7'«N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDWGDEPARTMENT HEATINGSYSTEM: �]GAS ❑ELECTRIC J <br /> 259�8810 <br /> . � OEMOUTION � ! COMBINATION i I BUILDING ! !MECHANICAL '� :PLUMBING �, I SIGN <br /> a�/w{�/{�_ � �y�x��iieooA[ss orr / ziv vHorve <br /> �'� /�/ Pi�'SPl �^ O' �'�D3? �J?fl-/J4�43 <br /> IEN4Ni L! V41LA�DB[55/� /t_ CItV ZIP PIbbE <br /> �/�' �//��� � ��r �/ ��� <br /> ARb�p[CLP�[51GNER U�RAD��ESS Gtv SiP PWNE <br /> ��� <br /> GF.NEPiLCnC1iF�LtOR I.IRiLq00PE55 LIiY ZIP VIqNE SLAIElKENSE� <br /> �./1 <br /> I.IiC,11R/111,�q/�CW1�PRC10R IAqIt�pOfiE^v$ G:IY IIP CIIONE $iR1flILEN$C� <br /> � <br /> 1'W�ApMGCJNiMCIOB M.1M1�D�PG55 Llry ZIP PrvONE SiNEl6EN5[� <br /> CONtflACi pqICE OF WDf18 <br /> �E�.[f1i�[-,YORN N'�6UUI.RE F iPGF it YIXVE� - � J CpryiAC1 PEP$IXI ANO P�IONE NO <br /> � �� il' a�/ I C�4 <br /> _�`_fE�F <br /> S�,SOI`Y <br /> i IiEREOV CERTIFV THAT I HAVE READ AND EXAMINED iH15 <br /> vnoaoseo usE ov am�pwc AppLiCATION AND KNOW THE SAME TO BE TFUE ANO CORRECT.ALL <br /> PpOVI510N5 OF LAWS AND ORDIN�NCES GOVERNING THIS TYPE OF <br /> �ecuot;cwvuorvoFveoven.v�s�owvee�owoe<rrnortwocoaics� WORK WILL BE COMPLETED WITH WHETHEF SPEGFIEO HEREIN OR <br /> w*— o�ocrc o� NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCLL THE PROVISIONS OF ANY <br /> ������ ��f� s �. OTHER SiATE OR LOCAL LAW REGULATING CONSTqUCTION OR THE <br /> PERFORh7ANCE OF CONSTRUCTION.THAT I AM AUTHORRED BY THE <br /> G�.. . ��� OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> � App��^qTiON IS MADE AND I COMPLY WITH THE STAiE <br /> Pl.RC[liAVID HVIABEP <br /> �7 � �ns-����V- �0�� CU. �AC�ORS�AW18.27RCWAND236200WAC. <br /> CONSLNUCiMYlIOANIENJER.ACDPE55.iF1EP11CNENUMOEP � � <br /> �:.,��....C>✓ /o/L_c143 <br /> PflOJECTADUHESS '�*�' � �^� <br /> /i v > > /��! SG ��,—.w��m�.,��«�;�M-. <br /> PLUTABING � AtECMANICAI <br /> NO. TYPE OF FI%TUNE Ofl ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET ITOI�ET� A C—A�HNDLG UNITS—HP <br /> BAtHTUB FORCEDAIRSVSTEMS—D.T.U. M E.A. <br /> LAVATOflV(WASH BASIN� UNIT HEATERS—B.T.U. M <br /> SH01vEfi CLOTHES DRYERS <br /> NITCHEN SINN 8 DISP VENTILATION FAN <br /> DISHWASMER RANGE HOOD <br /> LAUNDRY TRAV WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URIN�L I.;ETAL FIREPLACE(WOOD BURNING) <br /> �qINHING FOUHTAIN FIREPLACE INSERT <br /> FLOOfi DRAIN HEAT PUMC <br /> BAGNFLOW PREVENTEFS GAS PIPING <br /> ROCP GRAINS—RAW�EADEFS EXHAUST FAN <br /> SINK�SEFVICE—BAR.ETC.� <br /> SUBTOTAL S SUBTOTAL 5 <br /> PEP.MIT 5 —T PEFMII 5 <br /> TOTALFEE 5 TOTALFEE S <br /> FOR OFFICE USE ONLY: <br /> iPONi5f1p0.�x R[�RSEiBRCN $IpE$EiORCM PUNCII[ NIM1IV f(1 fEE AfCCIPiNO <br /> � � <br /> u,Eror.!�. mrnnen vecurtsrte ' FEES VALUATION FEE <br /> � YES � �. NO gUILOMG <br /> IY�[OfCMfiI NOO`SiOfliES pfarcu n,xi„ip;�xi�5 <br /> ��' PWMBING <br /> 5¢EOF9L�G RpESPPWnlEF5REQ0 OASEUENt MECN/NICAL <br /> � YES �-. NO -- <br /> CCCUPANCYtOAO FlR[ALMMPE00 NE�GNLLIMIIAiiON AODIT�ONALPUNGHECK <br /> OTIIER <br /> PEPS011 - -� <br /> SiALE�WLDiNG SUIiCNAHG[ <br /> ���r.��n. yur+servnovFyr_ CITYOFEVEHETT pi�pucwOnns <br /> ES-v2�� CJi-� LOCAL SALES <br /> oe.E �v a�/93 TAX COOE IS 3105 *oui I� <br /> .bv <br />