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• BUILOINGPROJECT IDENTIFICATI r[wu+n%v"KR
APPLICATION & PERMIT
, -
L"t""1"IA pt '-- � ft,l( )IN', 4 I ! C THICAt Pl. l!MpI Nf, ?At 11h NICALi U i-pfL b
PLAN CNE VKMATMIa
'L (S�OQ-t>o�l Ji .i�.� ��iil/l�l/ ✓ ILGCi111R.'PKJMMi � • f�
n1oa1E 1,G ti -1..E• . [ > - . 3.,i
CQNiwwClrw f �'
NAYI I
LETS -BYIIITfHE$-RECEP y,00/1In', '
4�uts,�I !� rKr 21 ?�_ IGHTING FIXTURES 5.00/1.00 , y
Ar"ORY .� .J �f S 1 -TV
- PPLIA_NCES • RESIDENTIAL.
w�.tfRBfri 't {•y,,
ANFIS 5.00 y i DATE of at"LICATIO61
7< �a,,ntEC .{) 2 914-f- pi'o , p•II- SIGNS -�-�- 8.00 PLAN CN CK FU NfJ-�
(MGINIfR F
_
tic No SIGNS TRANS. _ 3-� _
AN,:w . fN:,- /_�_ A r SPECIAL CIRCUIT ►ERrxT v�G.D'wtN)N
r Atf011[sy Q ) tt.w0 v 5.00
L'1ft Z Gap 2 P 'bra : B EMP. METER OR POLE INS. 16.00
AMLMANtY y -
A(xxtrsf MOTORS SEE FEE SCH. ✓
SERVICE CHANGE - 10.00
LL ? 1.10 Ns1l-h(1N•ITRA(10RS E*VIAMATN)N
� //._� 11
M 1 . :hereby affom that 1 am h00w of •ander p•I f III, of (lYp1m 9 a( �, I •��'�-y B(DG ELECt PLO YECN
(omnl .:a(B with Satroa 70061 of Unm,n 1 of ILK Su and L� tel,
f. 7 Pprlewtiom C+xk y hmae n a, tub h,p; Er,4 ( _ YadAt+•(t-- __.�.1�!_.7. ® ❑
= O'� - Lwtrnn+++,���,,,,la„ (1. Numf+<t ' I y�
a W, h-•. hi _._.(nrtincnx �LTyL,t _ r►'aaIL V �iet�•-� �.i (I -id.
Y S r 0*'41RD4TION-BUILFROL(LAR
y=t a 1 Ment+), affirm that I am earmpi from the Contractof'1 lr.tnvMISC REFER -.
to cTf R I law wu
for the folloy rtawm ett (S 7631.1. Bw»eaandPmftaw„n __ -PERM,' ISSUANCE �- 6.00 j -
ja 0 -' ' (oar Any of of ,ounly whkh requiem a pem.1 to wmtrwi.alter. _
T i < Z mlpnm, demduh ,x npau any atrwlwe, poor ion. nauamt ako [Lir "11- 1 Ir N,l FLEC / 414)
C Rgwn-, the appixanl (<x a,ah permit h. 6k a fgn<d HalHtltnl that TOTAL -
ht n Iw<„eeJ Pu!wanl
I. the pnmxorm M th<fml! Im , L-weme - n
.._� I.aw ifharltr4t:,xnrnerwulB wnh C
ane r
B(Lha that he taarn. c%mfhnmlonlMtht
� = O uN,xa, cx.on, ,xfel ten r1 th<re(rnm aad OTY PLUMBING PERMIT
a ti
th, ha (u khr alkFr<I rumptl x Any ,n latror of Sr,lwn' ill ' i4 STORIE ?vPf CDNStR
T 3 ... by any arph,a»t (o, . rrnn+k wtyetl.ihe sppll.mttoAz„dlrnahy 'ALTER•DRAIN & VENT -WATER (EA.) 4.00
( nuI enure than 1,r hundrrd do1Im(55061 1
1 a, owner .,1 th, rn+m,ty, Ix my er.'1pk,yee, wnh waken a, .----
therr x& ,-„•• wdl du fh, wmk and th, %I,-Ium n no! BACK FLOW PROTECT. DEVICE 2,00 'Ti qp-�--^-"pk= ,Tx
<nvnon
r f -Jed ,x otlefat kx ,il rs<, 1044. B+.u- and Pr -A, onl DRAINS-FLOOP F OOP, AREA,CONO. 4.00
(` dr Tht ('ontra tur i ! n.nw 1 Aw d xs hu: apply to an owner of--
"I",ty tho NMI& or -r--th--, and who doe, w;I..04 FIXTURES • PER TRAP 1.00 EO FT SLOOP • ,e +, L ACREAGE
hi-41oT thrtwo hn own rmrl..)m m -led that w,h ,mprme
mtnh ,nt not mttmkd o, offered hx -k If, h<rwrvrr, ihr bmtdugt (,AS - EA. SYSTEM - 1 INC. 4 OUTLETS 4.00
r unpmtmnent Is wld wnhm rent )ta nl complel- th, owner- GAS _ EA. SYSTEM - OVER 4 1EA.1 1.00 B(xIL mart
Nddtr wdt have the ten Jen of pf-w lCat he dw1 not hwld or ,m RLY IND ^...: A pB por.
pm `` rw rut}xxe of aalr I INDUSTRIAL WASTE INTER. 20.00
1 a, .rwnrt of the pRN.) am r-luameN ,untra,M4a writ• __ -
11.r pfo ,nnira,nx, h, wnatrwt the rmw t tst, 7614 Bu,lnrs„ LAWI. SPRINKLERS - 1 INC 5 V.B. 5.00 i "-' wwi -Ag L N0
and Vmlew.x,a ('ndt 1 he ('"trut,•-', L,anN• t a. soca Is
apply
to an owner of propcNy wM build- Mir, ,r, thereon. and who LAWN .;PRINKLERS - OVER S IEA.) 1.00
-Imt► for
t , a h pnRhlw
TRACT NG xnratoi L,,tmt Low SFWER SANITARY STORM EA. 200ft/8.00 _vv
I am racm;+l +.Harr &, _... _ . hat L hx Iho NATER HEATER W;,/ENT 4.00
_-
•swnrr WATER SYSTEM 4.00 Ace DArE A ItfAi.i
%0kKI Rti' (OMPIMATR)N L)Er 1.ARAT1)N WATER TREATING EOU10 4.00
1 h,rt Ny atfirnl (hal k
w haat aLMrfb at. n(aams n+t. ila+,ur, _ - --
a .rrt,l„alt r,f So,
(„m(.....,ar inwran n• a ,rndxd [Nc Sftf NO
I..f SPAM. f •.<RGV T 24
REFER TO OREi-
[j9 ❑ ❑ I
CL yr ! R11f i( 411 U1 I \I'MPl3 t ttl\ 11uM WORM ItsPERMIT ISSUANCE 6:Loon zawI.i u cN
Lu _ (T)IiPENSATkf% l%SVRAA(I v G CONI, LK h('f PI t I
CL O + if .•-onp need not Ix ;.mpkted f th, (rano o Inr .w,❑
.., 1)iw, v N� I
V O hunJn . ffi•^1a•, 111WIrx kat -. -. ___ -.__ _ _... aw wraFut�w....1
I •ret,• tha, m the pcOmman- of the w,x► trx whwh ihm 1. QTY MECHANICAL F cRMIT FrEE�J_ I- mel n na J I ,h." not tmpkq an, peru,nm an) manna W., IU hr r, w.tw,t w th, Mm►,ri l, mlx nMlw.n 1hl4tTiwALTER OR Af)U TO MECH 4.0gull I)\u1141 1U APPIIt 491 it .11, t. a Iho f,nop au nt I . ,mpt,- v•w. hot,W 1 t whyt ,h w Hr -n , ,w,pettut- IAPPLIANCE 40PLAN CHLI AJ Itx l0%. l de ,• , I Inw,lh "m"P4 wonU r: ,,..,..,, o, ahn 1-0 d,.:. :.,...J,,.o►vl AIR HANDLING UNIT (TO 10j=CF M 1 301\,IOtt ;, -\LI\I \r. 41.1\tl AIRHAI�L.N�G 11PNT 10VER t0 C:.�MI S-p5EfSMIC FEE. �L
1h 1 r .• ,• , ,a+.1,u I... h 1EXHAUST HOOD (WITH DLWT1 200
-,, r.. ,I n.. w •.. nw wh..+• tt,., k +,_n . 'g,
FMICl10F1• M ..
a j HE 1TINli UNIT (TO 100,000 PTV )
HEATING UNITI&ER 1000008 T If 1750 _ fLECTNIC A `
nIdth-M4.afwmanJ .tut wen Inr .tmr VENTILATION FAN (SINGLE.) 11x1 ' --
•,•b •nnatnr .,n•,a 1 apo to .un1p11 wnh
all
a, and
_ PLUMgt NI:
.nu•na+ar, amt .tart 4w, rr46rtik h, Mnldn+f ,onur,ntlon and BOILER C(;wP(3 H P Of 100.000ILT .) 4.00
hm+$ aattax ra mrr<,tnla+ro N th. ,m) to n,i:+ ,q,on 1hr gO1LER COMP tDww Igp,O(fp 8TUI SE[ (kE SCN MECHANICAL
alx>, • mtmeu,ed e -natty Lx m,pt,I,nn purix.w•,
I r,'• Matte 1•+,/,f ,M1, D+•+d) I ►rtp hawk- the ( N) of MiSC REFER TO ORD -
(If
k,rrtlw,+ alml•.a balyldle. ,yl�. ,.nU and nkrn,e, whwh - __. __ - - _ 1
At4m.t +A{,I <, ,n .onwrfwen,t of tnc PERMIT ISSUANCE 3.00 ; LR• CONST.. TAX
+IpIB �`fwtlMr a fCN. CONT LIC Nt, WGN
TOTAI •, a Z �7 4 .[7'
I
CIT: OF OTEPTIND INSPECIIT� RECORD
(0�- CE CDMY
?'ER,fIT I S`" TED
cE e�ca-I
M.isc.
FINAL INSPECHONS DATE I INSP.
Gas
ectric /-
�ry'
Pad Cert
re- ite - I
Thderf-loor Girders —�—
tame
YYatlDCNKrELS
Tr�t.alIs
Other x�.... r
ELE=,, L_AL a4TE INW.
Pru iwr Pnl o
I
PLi1N8ING DATE INSP.
BackfloM _
pT
EI.F.cnuCAL DATE INST.
Underfloor S.M. _
Ducts Insulation _
Fire ers
F_i_�r-- .ace
Grease Duct h Hood
One Hour
sate Drain
uip hent Ancliorage
Flues � >. r -r - Other-
_
of ro ve -
BLDG. DMT.
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a11s
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Building
livistm
4
PRIOME
BLDG. TYPE
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ACC.
ADD S
PROS
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d9J.8' y's �" Ore - 3
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CONST. TAX
PUBLIC Vint >
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