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<br />APPLiCATlO�. FOR CONSTRUCTI.,id PERMIT
<br />TO BF "OMPLETED IN INK—F�EASE PRINT
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<br />DEMOLITION CCMOINATION
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<br />.tNEW �DDI7i01� nI.iLHATION REPAIR I[h�JLITION WOODSTOVE.FRPLINS[RT_ BUILDINGRELOCNIOt�
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<br />r��,'rosfDusEcununnr+n I HERFBV CERTIP'i 1HAT I HAVE READ ANO EXi�MINED TMIti
<br />�. N '��_'�.� �-, :y-� i•_�- �� �•� APPLICATION AND KNOW iH:: SAME TO BE TRUE AND CORREC7 M I.
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<br />� i lV0?h WILI �E COh1PL�1CD WITH WHETHER SPECIFIED HEFICW OR
<br />„�.�_2(�_ nirv n ��� _�,.�� �`I-r? �./� �/ 'L- NOT iHE GRANTING Of- A PERMIT DOES NOT P'�ESiIME TO GIVE
<br />�_ � AUINOFIiY TO VIOLATE OR CANC[L THr. PFOVIS�ONS OF ANY
<br />. _� r� � '� � .. .F �! I i� � OiH[R STAT[ OR LOCAL lA\Y REGULATING GONSTRUCTION OR ?N[
<br />� �� �- -� � P[FfOfiMPNCE OF CONSTRUCTION. "IHAT I AIA AUTHORIIEO BV TH[
<br />=Z0 F '%I �?�vN[R OF TMIS PROPFIiTV TO PERFORM THE WORN FOR WNII.H
<br />. ����_S__. �- _.___' _. Af`PIJCATION IS IAAf1C AND I f.O1dPLV \YITH TH[ STAiF
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<br />N0. TYPE OF FIXTUFE OR ITEM
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<br />- �� �ATHTUB
<br />$ LAVAIOHY � WASH BASINI
<br />� SHOWER
<br />_ I FITCHEN SINK 6 DISP
<br />DISHWASHER
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<br />LAUNDRVTRAV
<br />I CLOTHES WASHER
<br />DRINKING FOUNTAIN __
<br />FLOOF DRAIN
<br />DACKFLOW PR[VENiERS
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<br />_ __ SINK �SERVICE _�AR ETf �
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<br />LOCAL SALES
<br />�til�;� I `�� I 1AX COOE IS 3105
<br />NO. TYPE OF EOUIPMENT _
<br />AC- AHNOLGUNITS -HP
<br />� f ORCED AIR S STEI.Iti � T U Id L A.
<br />UNI* HEATER 0 TU fd _
<br />i: "y CLO7HF5 DRVFPS ___ _ __ _ _
<br />. V@NTILATION FAN
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<br />� W.�TERHEATER
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<br />1 Idf' TAL FIREPLACE 8 CNIMNEV
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<br />TOTAL
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