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APPLICAIVI IL) t-.ILL nyr-,v rs ,rh....,... .. -.-- - -. —_-
' IERMIt NUbIDER '
dUILOINGPROJECT IDENTIFICA .'_ .APPLICATION & PE
IWLOma .. -
Apo BUILDING ELECTRICAL .PLUMBING MECHANICAL
L,ri/O �' ri r �E^ ` t TT , . T t'+. 3Cy e 1 [l a fjOtN PLAN CHECK YALIDA`ION
owx s• . ,;d ! ECE'�R:.IL4pRM �`- ?'i''Y t f A�:rM
Nkl - PHONE
cpxrnacrona OUTLETS. SWITCHES - RECEP 10.0011 UU
•
r..ME �n�/f
uc NU. Ir LIGHTING FIXTURES - 10.0011.00
CWrtANCroxs - PPLIANCES - RESIDENTIAL 4100 ".
pap!{ 10.00 DATE OF APPLICATION
PANELS
y�-��, PNOrvE � pkpN H F
AHCnITTCr
PANELS (OVER 200 AMP) 20.00
on - 3.00 ..
'Exmxen UCxo SIGNS TRANS.
-
.. 6.00 PEIIMIT VALIDATION
ARCH. on ENG. . SPECIAL' CIRCUIT
Apon Faa - - .
- an TEMP. METER OR POLE INS.. _: 20.00
Appwaaxr{' .. - ' MOTORS, - SEE FEE SCH.
AD Raas •, F
SERVICE CHANGE. 2000
TEMP. POLE 30.00
LICENSED CONTRACfCSRS fafCL.+.RAT10N -
I hereby arnrm that I am licensed Ode pnedlin•n of Ch Ptee9 .'169 AN R E'
lCOmmencil with Section' 7000)' Of Division l of it a Bua IKtt and - BLUO VLECI PLO MECH.
profession, CCod ad 1 n b I. pull for tt t � ,. .�
List, Llc. Nonfat' - -
Date_ CO IITICIO
OWNER BUILDER DECLARATION REFER TO ORO h a
1 hemby rfOCm That I am exempt from'1h[CanlroclOri LianK MISD. - - .VALUATION - SIFT.
Lew for the following meson. IS... 70) I.S, Bush., and Prefeasmm PERMIT ISSUANCE 1000.
Code: Any C11101 Worry which re4'Ihea Perm11 In conHw.Lahe'. ELEC. LONTR: LIC. NO ELEC
ImProre, dcmOlhh Or repair any true lurt liar to it, NStunre:elw - TOTAL ERMIT
ssgnim the PPpllc n1 for such Peemn 10 DI dance tmlanern that ,• :
he le lleensed.puro nil thClo,drI soflhe CenlMcwia Lt... ! ', 1 '1d YY .a 0 r ,.y1YL]]1 MEC.
Lau(Chapter 9('alnmrachus vellh SecN n1000)of Divlsron laflla '.y r'.fiaZ� r P•}1 f1ABl Y�ITERp'i�z',J'A_ v kt�:l
Bwmess end Professions Code) er that he is eaempl Ihere...... d GTra La !c ,�4 n { i e t • -4V STORIES TYPE CUNSTR..
we aasb for the alleged exemption. Any violation Ofscipon 1015 �] F. •_.:A.• `• -.lr • !,- -< n• .
by any applicanl for o pump whild' the 0 plkam to a civil penally ALTER-DRAIN III VENT- WATER.IEA.1 6.00: ''
of net Mo. than five hundr -J da br,fS500) )1 - es ai
❑ I, as owner or 11th property r my employee wth. ¢ BACK FLOW PROTECT. DEVICE: 4,00 Cc. a UP RFC. UNITS
their wit cwagpostion. will do the work and the stwcture h not
intended or '0 Card for ale IS" )044, susuc s and Professions DRAINS- FLOOR, ROOF, AREA, OONO. B.DO
Code: Th. C.Wouwrf License LFw d not uPPIY In an owner Of - B.OD aG FT. f9OOR AREA �' TOTALACnEAOE"
pA,u; y who builds or. improve thereon'and w o deco mM work ,FIXTURES -PER TRAP , ..
bimself or thiough his own inlployees Provided that such improve- GAS -EA S�STF.M 1'INC.4 OUTLETS. 6.00 .. -
m[nt, air nor Intended of Nrcred f0 KN If, h wm the bulldinp
or Imprwemclt,is wW within one you f mPl tin the r GAS • EA, SYST M - OVER 4 MAJ - 2:00 - ...Lou.. uaE.
builder will felt the burden of pro i g that he. did net build r I n- RES IND. CON' PO ' Onnr
Provo for Purpose of sak,3 INDUSTRIALWASTE INTER. 3000 : ❑; O
❑ I: u owner o� the property. am exclusively CYnlrac ag with :.
licensed conuaciee to eonatnat the Projeel (sec. 7044, Business LAWN SPRINKLERS
• 1 INC 6,V.0. 8.00 ggOR ARCEL NO.
and Pwfcasions Code: The Cunlra[lie ", License Law does not aPPIY
to an owner, of Property' who holds W improve thereon. and who -LAWN SPRINKLERS -OVER 61EA.1' 1.00: •' ,:., .
contracts for such projects with a mntnrwl(A licensed Pollan. to SEWERSAN'TARY STORM EA. 200ft /10.00 -: TRACT. NO. PARCEL NO..
for L'mnmctori License Law: ., R,dP.C. foYlhis :-
_ b lam exknipl undo sic ' ,WATER HEATER WIVENT 8.00 . .
°ner Dae— WATER SYSTEM' "'.5.00 ACC.OATa, 'ACC.FILENO..
gwner
WURKF .RS'COA(PENSATIONDECIARATION' WATER TREATING EQUIP. 5.00
I h rebyy affirm that 1 have a arllrkiiii, of Consent 1p KIf Ins c. - - 20NING ENO.. BITE N0.
.' Or • rli Cate or Workers COW, tl n resonance u tllicd � : '
- copy the B Lab C.). �� ��••� .' - :. -
POII[y NO�`.f]JTPanY- FIRE SPRINK ENERGY TN
`b'CcrliOcd pY 1 hereby fur i hed - .
�...Lerr11 oy Al de ell inspect �uon' MISS• ,' REFER TO ORD. Y� .R� Y❑ Nn
A, PIKanM1 --
CERTIPICAT [OFF. %F.fdYTIUN fROkI WORKERS PERMIT ISSUANCE" 10.00. PLaoO ZONE
-CONIPENSATION INSURANCE PLO. CONin.' uc. NO : PLO, 113 'N� .'YD NQ.
TOTAL
IThp wetian:laed not he romYleted if the per mlt n To', ant _ .yyam'
kindred dollars(SIOD) or ten) 77 ka i 1v rNl i a ddI�aY ht (kl "P A
I grlifY Ihaf in the per(ormah.•e of the work for col h Ibis per,
MEBy(A,IOTi -.t
mH It issued. I shell not employ any Panpn In any manner o u so - •5"J F� s e •i,d fS !,• d :7.1.
Y •
became subject to the Workeri Compensation Laws of California BUILDING' -
'Dal, Applies.[ - ALTER O" ADD.'�Q02,f r' r 5.00
NOTICE TO APPLICANT: If, tit,, noting Ihh CerllnCee Of Er - 6.00 ' 'PLAN CHECK
' emotion, you slmutd become suih)ccl to the %Vorkan'COFfNWf i^n APPLIANCE' - FEE.
pmvbno, offhe Labor. Code. you must fo1111wi1b camPly with AIR HANDLING UNI 1 'r ,4.00 —_
wrh ,wj too, or Ihls rani. shall be, deemed avoked,
CONSTRUCTION LENDING AGENCY
AIR HANDLING UNI 1 Lfi.DD - SEISMIC FEE_
1 hereby unbm that liters If a aoexlmlion lending avency for EXHAUST HOOD (WITH DUCTI 5.00 MICROFILM '
the lr6rmmace of the work for which this permit b hsupdJ5.CC.' HEATING UNIT (TO 100,0W B.T.U.) 8.00 _
,101/1, 47w.C.).
Lenders Name— — HEATING UNIT (OVER l 00,OD0 B:T.U,10.60 ELECTRIC ,
LtnAEro Address — - - -- -
IrmffyOMtnmreradthkarPli eaten and otter mat the able VENTILAt10N FAN ISINGLE) 4.00 PLUMBING -
WT.OrriarwAs C.rc,l. I agow Is comllY wilts all clly and ubely BOILER•COMPM H.P. or 100,000 B.T.U.) 5.00
oWfalnm and stem Llws alaing In budding son .... C.Im a J _ -
heathy wn!w,I" relcuomliees of this city to enter NINW Ile BOI LER•COMP 10swr 100,000 BTUI SEE FEE SCH. MECHANICAL C' -
ahoao-memonrdproPrrlYfurinslrlionpurpmra gEFEq TO, ORD.
(We) rate In rave. md'WhIl and keep hzrmle 1 to ❑11 f MISC. - CONST. TAX
(•u no awtom hill litt s, lu:em Ns a 1 and repro s wMHh .PERMIT ISSUANCE - 10 0. �Q .-
n Y toy vJY,o gainO sblA CIIY In eenKOUent of 1 he UC. NO TDTAL I'y
an 1 o II114fc I - .1. EC CONT ` �y / } $��^Lt�4 /
Sipnama of APP
�
coil( nn lw r TN :IhI
APPLICAIVI IL) t-.ILL nyr-,v rs ,rh....,... .. -.-- - -. —_-
' IERMIt NUbIDER '
dUILOINGPROJECT IDENTIFICA .'_ .APPLICATION & PE
IWLOma .. -
Apo BUILDING ELECTRICAL .PLUMBING MECHANICAL
L,ri/O �' ri r �E^ ` t TT , . T t'+. 3Cy e 1 [l a fjOtN PLAN CHECK YALIDA`ION
owx s• . ,;d ! ECE'�R:.IL4pRM �`- ?'i''Y t f A�:rM
Nkl - PHONE
cpxrnacrona OUTLETS. SWITCHES - RECEP 10.0011 UU
•
r..ME �n�/f
uc NU. Ir LIGHTING FIXTURES - 10.0011.00
CWrtANCroxs - PPLIANCES - RESIDENTIAL 4100 ".
pap!{ 10.00 DATE OF APPLICATION
PANELS
y�-��, PNOrvE � pkpN H F
AHCnITTCr
PANELS (OVER 200 AMP) 20.00
on - 3.00 ..
'Exmxen UCxo SIGNS TRANS.
-
.. 6.00 PEIIMIT VALIDATION
ARCH. on ENG. . SPECIAL' CIRCUIT
Apon Faa - - .
- an TEMP. METER OR POLE INS.. _: 20.00
Appwaaxr{' .. - ' MOTORS, - SEE FEE SCH.
AD Raas •, F
SERVICE CHANGE. 2000
TEMP. POLE 30.00
LICENSED CONTRACfCSRS fafCL.+.RAT10N -
I hereby arnrm that I am licensed Ode pnedlin•n of Ch Ptee9 .'169 AN R E'
lCOmmencil with Section' 7000)' Of Division l of it a Bua IKtt and - BLUO VLECI PLO MECH.
profession, CCod ad 1 n b I. pull for tt t � ,. .�
List, Llc. Nonfat' - -
Date_ CO IITICIO
OWNER BUILDER DECLARATION REFER TO ORO h a
1 hemby rfOCm That I am exempt from'1h[CanlroclOri LianK MISD. - - .VALUATION - SIFT.
Lew for the following meson. IS... 70) I.S, Bush., and Prefeasmm PERMIT ISSUANCE 1000.
Code: Any C11101 Worry which re4'Ihea Perm11 In conHw.Lahe'. ELEC. LONTR: LIC. NO ELEC
ImProre, dcmOlhh Or repair any true lurt liar to it, NStunre:elw - TOTAL ERMIT
ssgnim the PPpllc n1 for such Peemn 10 DI dance tmlanern that ,• :
he le lleensed.puro nil thClo,drI soflhe CenlMcwia Lt... ! ', 1 '1d YY .a 0 r ,.y1YL]]1 MEC.
Lau(Chapter 9('alnmrachus vellh SecN n1000)of Divlsron laflla '.y r'.fiaZ� r P•}1 f1ABl Y�ITERp'i�z',J'A_ v kt�:l
Bwmess end Professions Code) er that he is eaempl Ihere...... d GTra La !c ,�4 n { i e t • -4V STORIES TYPE CUNSTR..
we aasb for the alleged exemption. Any violation Ofscipon 1015 �] F. •_.:A.• `• -.lr • !,- -< n• .
by any applicanl for o pump whild' the 0 plkam to a civil penally ALTER-DRAIN III VENT- WATER.IEA.1 6.00: ''
of net Mo. than five hundr -J da br,fS500) )1 - es ai
❑ I, as owner or 11th property r my employee wth. ¢ BACK FLOW PROTECT. DEVICE: 4,00 Cc. a UP RFC. UNITS
their wit cwagpostion. will do the work and the stwcture h not
intended or '0 Card for ale IS" )044, susuc s and Professions DRAINS- FLOOR, ROOF, AREA, OONO. B.DO
Code: Th. C.Wouwrf License LFw d not uPPIY In an owner Of - B.OD aG FT. f9OOR AREA �' TOTALACnEAOE"
pA,u; y who builds or. improve thereon'and w o deco mM work ,FIXTURES -PER TRAP , ..
bimself or thiough his own inlployees Provided that such improve- GAS -EA S�STF.M 1'INC.4 OUTLETS. 6.00 .. -
m[nt, air nor Intended of Nrcred f0 KN If, h wm the bulldinp
or Imprwemclt,is wW within one you f mPl tin the r GAS • EA, SYST M - OVER 4 MAJ - 2:00 - ...Lou.. uaE.
builder will felt the burden of pro i g that he. did net build r I n- RES IND. CON' PO ' Onnr
Provo for Purpose of sak,3 INDUSTRIALWASTE INTER. 3000 : ❑; O
❑ I: u owner o� the property. am exclusively CYnlrac ag with :.
licensed conuaciee to eonatnat the Projeel (sec. 7044, Business LAWN SPRINKLERS
• 1 INC 6,V.0. 8.00 ggOR ARCEL NO.
and Pwfcasions Code: The Cunlra[lie ", License Law does not aPPIY
to an owner, of Property' who holds W improve thereon. and who -LAWN SPRINKLERS -OVER 61EA.1' 1.00: •' ,:., .
contracts for such projects with a mntnrwl(A licensed Pollan. to SEWERSAN'TARY STORM EA. 200ft /10.00 -: TRACT. NO. PARCEL NO..
for L'mnmctori License Law: ., R,dP.C. foYlhis :-
_ b lam exknipl undo sic ' ,WATER HEATER WIVENT 8.00 . .
°ner Dae— WATER SYSTEM' "'.5.00 ACC.OATa, 'ACC.FILENO..
gwner
WURKF .RS'COA(PENSATIONDECIARATION' WATER TREATING EQUIP. 5.00
I h rebyy affirm that 1 have a arllrkiiii, of Consent 1p KIf Ins c. - - 20NING ENO.. BITE N0.
.' Or • rli Cate or Workers COW, tl n resonance u tllicd � : '
- copy the B Lab C.). �� ��••� .' - :. -
POII[y NO�`.f]JTPanY- FIRE SPRINK ENERGY TN
`b'CcrliOcd pY 1 hereby fur i hed - .
�...Lerr11 oy Al de ell inspect �uon' MISS• ,' REFER TO ORD. Y� .R� Y❑ Nn
A, PIKanM1 --
CERTIPICAT [OFF. %F.fdYTIUN fROkI WORKERS PERMIT ISSUANCE" 10.00. PLaoO ZONE
-CONIPENSATION INSURANCE PLO. CONin.' uc. NO : PLO, 113 'N� .'YD NQ.
TOTAL
IThp wetian:laed not he romYleted if the per mlt n To', ant _ .yyam'
kindred dollars(SIOD) or ten) 77 ka i 1v rNl i a ddI�aY ht (kl "P A
I grlifY Ihaf in the per(ormah.•e of the work for col h Ibis per,
MEBy(A,IOTi -.t
mH It issued. I shell not employ any Panpn In any manner o u so - •5"J F� s e •i,d fS !,• d :7.1.
Y •
became subject to the Workeri Compensation Laws of California BUILDING' -
'Dal, Applies.[ - ALTER O" ADD.'�Q02,f r' r 5.00
NOTICE TO APPLICANT: If, tit,, noting Ihh CerllnCee Of Er - 6.00 ' 'PLAN CHECK
' emotion, you slmutd become suih)ccl to the %Vorkan'COFfNWf i^n APPLIANCE' - FEE.
pmvbno, offhe Labor. Code. you must fo1111wi1b camPly with AIR HANDLING UNI 1 'r ,4.00 —_
wrh ,wj too, or Ihls rani. shall be, deemed avoked,
CONSTRUCTION LENDING AGENCY
AIR HANDLING UNI 1 Lfi.DD - SEISMIC FEE_
1 hereby unbm that liters If a aoexlmlion lending avency for EXHAUST HOOD (WITH DUCTI 5.00 MICROFILM '
the lr6rmmace of the work for which this permit b hsupdJ5.CC.' HEATING UNIT (TO 100,0W B.T.U.) 8.00 _
,101/1, 47w.C.).
Lenders Name— — HEATING UNIT (OVER l 00,OD0 B:T.U,10.60 ELECTRIC ,
LtnAEro Address — - - -- -
IrmffyOMtnmreradthkarPli eaten and otter mat the able VENTILAt10N FAN ISINGLE) 4.00 PLUMBING -
WT.OrriarwAs C.rc,l. I agow Is comllY wilts all clly and ubely BOILER•COMPM H.P. or 100,000 B.T.U.) 5.00
oWfalnm and stem Llws alaing In budding son .... C.Im a J _ -
heathy wn!w,I" relcuomliees of this city to enter NINW Ile BOI LER•COMP 10swr 100,000 BTUI SEE FEE SCH. MECHANICAL C' -
ahoao-memonrdproPrrlYfurinslrlionpurpmra gEFEq TO, ORD.
(We) rate In rave. md'WhIl and keep hzrmle 1 to ❑11 f MISC. - CONST. TAX
(•u no awtom hill litt s, lu:em Ns a 1 and repro s wMHh .PERMIT ISSUANCE - 10 0. �Q .-
n Y toy vJY,o gainO sblA CIIY In eenKOUent of 1 he UC. NO TDTAL I'y
an 1 o II114fc I - .1. EC CONT ` �y / } $��^Lt�4 /
Sipnama of APP