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28435 (2) APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY CI'1'1' UIQ CUI'Is R'I'INU 1.-61.h.L"I RICA I, IYIRNIII NO BUILDING 0Is u ER'I'N APPLICATION/1'ERM H' I'L1IMIII NU�NII:CILkNIC L 28435 IIIIII,BINI:1•Ru.IRCI'IUP.N'I'114CA I'IIIN lit IFI'IN';AI A'RI;SS: SANHARI'NO. Aldd,ll'AI ION SIR0111'1 A,O\II! I 1 OI%NIIR�A%11: �`� HION1I.: ` (VNI It ACI I ill S Nn III HE (C, 2 (�l�)wf»f LW Nl l: —1—k _/��� f CTf �—'gel_cT nl l l Q�f'L/J7G s�fC/c1.Ll NA MINI HIR.w 18111;1:("I&NIHNIilit: 0 CON I,\CI, NIONP„ QTY. ELECTRIC PERMIT FEE BUILDING PERMIT INFO K ' � I11�fl V)a.-I'F P/- ^ ciPINM1IILtiS1ANCi �l _\ ' d LIC IiNSI;PCONIRA(IIIIR'SOIiCI,ARAIIIIN AITIJANCLS-HIiSINI!N'HAI. Ihnchynllimuh:n lens liwwnu•dnndr' Icb. 1ln..... irr 'IL LII1111'S1'R Ir1IGN pz% p'nv'InIc .' -plrr' Fur FOO Sir in') 0M❑ivi,i'nl sol the lhnine,a mus l4nlewinn4 Cul.,1111111111 licm'tr'" I'ANFIX 1Fc-1 lull bore:mll dlr'I. C i W 111"P I gN'AM106 V Lirrn.r(au,. 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SInRIIE. 1'SI'I!t'GNSI1114"I ION y3. will Jn lbr,nrl.unJ lh,,nudnrC is nal inlcndnl anN femJ insist,(SO,.7104.Ihn n..f pndr. ,Crvle:Ilse Cnnlrnce'i s Lice'.Ueu dine,nnl apply In an n esl Ons"o5 aim lnrild,u in'rrn.LEON can,nnd,Ilndrs,.wcn wink nit'w`RoOt,nnh:hhi, r '1 hhul nuchirn 11 nwnJcdnl Illlcred hnv:Jc,IL OCC,0110111' ILLS.IINIIS In� c"'A"knildivu a' prmrI,1,nnm.In ac rlt,r lnrilrhnF nrin'Prn a vin thatAw didn esneyur ofiniproainn.111cnw110— 'I 1 Fnildcr,ill Iraw It,e M1nnicr'nI P'avinF Incl Ire din net bnilA ur inlpa'vr ILL purlxnc nl cJC.1. ❑ I.;, nl the pugrn3,'. u'Irniwlyr lnbaninguilt,licrllaA rnnlraun4ln QTY. PLUMBING PERMIT FEE I1(1011/uN11 MEN n.nE nt tl c 1"ajTO IST,,IIIb(It inc, .loll Isn't,„ill's,('IIs$,'Ihr C''.rnn"..., .im vLn.drn nV'Ply..........rocsnl Plul'vI I)'nI bell'est inrinl ,wtlsnuoll,:uu1 11I;RMI IIS.SIIAN(H u Ins,E uul,In, n,I ,L.jT,1w il),nrnnlr.¢n'.W I"ntnllnn,lrnnnu dm('onnninn, Allee :u'. MAIIR GRAIN&VVN'I'-WIN 11:11 WA) FEE SUMMARY ❑ am r,rmpl'sodas SCC. .II R I'I'Inr ILi,m:rvnr I II II ti1PIaiTs IIACH I:I.OW I'ROI CCI'.D[VICH SANIIARI' 1' N (Iwn'r D”, DRAINIS- RIiC;IPI x 19J VIk.NOIIP,"AIt1iA:CONII.' WORKMAN('OMIll;NSA'lION UCCLAItA'I IDN SCHOOL'IAN 5' N .IG�1lmvhy al lirnr'hul I M1ave n ev'lilicale ul nnnrnl IO,elrll'sne.n':I cenitioah,If Nlil'hll'I'N Il]'111111i.S-I'I!Ii'1'RAP PARK I'lili 1' N \1\nlc;,Inl"'m:nian lnennnrr nru'eliliM rnpp lLcrmd lSee.!RIXIa:It,C.I,Irirl' Rlil'HIM N lI :dl cnydurrd,rrnllr'It,iy.cn•'h' GAS-P.A.SI'ti l I(NI-I INC.J OII I1Ii I S 1"'I p � 1 IIIIILUING DIVISION I'lili5 i GAS 1A.SYSICNhOVP,114117A/ 1 I'LANCHIECF I'Eli I �s ❑ I Crllilird.nip'it t,cmhv barn;toed, Y— ❑ COI1610%, lnryMisled wish dles,n)illyruiunnivitinn. 1;1t1!AS141 1 �(i 11:1 ( is'loR CHAPINC 1111; fllkllli(',\I'Ii OP I!RISNII•I'IGN I'H0N10.'ORKCRS' I-'i'. hp1:n51i' AI' 1SORSIii1; COMMENSAI'ION INSIINANCI; I - Old'"Ol."'Is"dnnlLaun Iti'd it d'ry'ennili,lar nn,l'I'NIIaA,Io1IhLr,;slIw) S11 WIIR-SA NI'I n RI".Sri ORN11iA.:IMIPi. RNRIt(IY 11.1; „I 111llih shot In lha lrctlnnnunrr ul the w,nk In,which llriyx•nuit i,i,nndJ,l rlsnll INA HIP IICA'IPN w/vl(N'I'/IiLI§'IN nI sops... : v per n'y 1'r n d,In Mane auhjecl I.,the Wes.kers PAIII Cnngan,alirnrl na,011'Ailnmiu1Dle W'A'II:RSYS'II:NIf1k1iA'I'IN(1 Dale If...inI Ayp1IClnn � Q NIII ICI;IO AI'I'LICAN 1:ll.xhcrnmkin, In'Crn11111Hcul l l"I"Ll fan.vas.I III NhW RI[SIOI;NI IAI.VIAIR. SQ.191 'IOI'AI.: y n<C oo....le"I Ind"\Van kert('i ngnn,.Nlion pin 1 ,nmol do L:Ifxn Clxlc.v"11r nn1,1 a - 1...111"ht,coruply„Ilt, ndIPaI,Ian,Irrmia Prn'd1OnIl lsr JrnnrA m.nAcA. III 111DINII h P.Ii 11..1 Q I ON%1101(71'ION I.HNOING AGIINC\. SIISNIl1'I IT. ll a � Z It,culm_ :160. ik,le rc i,a']nrclISO,. lending ap<n,'lunhrl`'dmm:mrr'd - UO the u,nA Ln sllich Illi,IYrnril is ivvuvlfSrr.UN1,Ci¢CI 'I If1.rCIHlC 19!li f (nine.',Noor u” F Leaner',Adhe,4 QTY, MECUANICALPERMBT FEIi PLGNn1ING IIieGr I scally dl'nt I h:nc vu.l In,uprliullirnl onJ a:no It,nr Ilrc'Il.wr inlnnnalilru i, — SHE, NICAI.Iiil! 0. nn nvl.1z I'LL( 't, .fhaRrilya'ul0esnnl,r ndinwnc,:nlll arnr law'v"Lein,l„ VINNIII ISSIIAN('1: I—' Willi ngu rr,Rlmllne.:nul haehfuudmrnCrrp.. In uae,al lt,krin o"nl<t'liI, On, (v INSIRGCIION IAN V Z nM"c-I"r'r'lun'rrl pugnrl,'less in1ILVOinn pmpe,t%. Al:II;R"IC Allis 141 N114 It, 1\lin ngmr no IIldc'sIn it,; I kcop In nada„the 1'it,Id('nln1li Is..g',.....l IiuFJisir,,illJ. nivuwwl'de'p'n `,Ilial....... wnvuu sur ugnina aNiJCis, AIRILWGI.WE IINI I'r'IO 11101111 NII IIs"nl,ernrr "r III la'IllitrF 11111'1 1' 'I. n \IH It,\NPLINII IINII'p IYIiH IIS IMN'(ITU SignannIIs gNyurnlC.nwmnnr Ran. I NHAUS1'II000IWOIdh'l'' MMI) IIA%AItPOIg NIAII.R1AI..CGIS1'IJISIIRIi IIIACIINIIIINIInORNIIXM111114 U.ne Ro-ripla Wild ',1I III; t t I 'L IJ' i. 1' 1 Is II E nr.1 ill "— N,d 11 ( Iv'I n'M'nr p'l I txl 1'1'1 n' I.1_n I It,-IIh' W.S'I Is 111 A'I ING GNI I if IVI'If PHI IMNI IF I'111 I(xic.SCI 55llln] VI NI ILA ON VAN ISINOLE RPSIPI Cl 5'r, ❑No _ _S ISSUANCE Ila\'I P; 11,111[;If I"Nil'.fill'sW 11.1111s,111111 l\'ill lbs applil ore In lnlulc lnrilAllrg est.rp.nll rnr rgniprnnnln Jeviu�\wlli'n.�rni1 _ Il:vunllnl.'a II unhno1n',n 1,u,nd n1d by Jm Ilap Neu All Qnullly Nlunngrr'sv"I IIOILIilf-i ONW(I)VUR IINIINXI IIIA) tlhtdn.' ❑1'r, ❑N„ NliW RRSIDIiN11M,NIH I1. SQ,PI'. I have re:ul Ih<hn,:IIrI.....nr:nand,'cyllhcn'On,susses Cb,"Le,1'!15 est In, Jut 111 11. T1?L FS'II I S"Hon,21501.251's, 1 ,5311 low llh:n d it h, II' LI ' 11'1'. " 1 r far ...........'III,I .Iit, In, win s I I 'I nn".hid ...... l rl nim,to A, 1' ( I1j', d r. 1N, 1 Os t O.n"d.l, t PLIT 1111'AI: ISSIIID 111: OFFICE