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21119
BUILDING PERMIT APPI-CATION CO FY TIG,AR® DATE
THE UNDERSIGNED HEREBY APPLIES FOR 4PERMIT FOR -1 HE WORK HEREIN INDICATED BUILDER PHONE _
OR AS SHOWN AND APPROVED IN THE ACCC,MPANYING PLANS AND SPECIFICATIONS Q NERrONF _
4Cjq'53- LOT NO(�.
OWNER JOP ADDRESS _ HOME ADDRE;S 77
~—' ARCHITECT
ENGINEER
BUILDER ADDRESS _ _ DEaIGNER
STRUCTURE ❑NEW ❑REMODEL, ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑OEMOL.ITION
❑ PFSIDENCE ryryl._ICOMM ❑EDUCATIONAL ❑GOV'T CrntLIGIOUSOPATIO ❑C.R FORT ❑GARAGE C7 STORAGE FISLAB []FENCE
DBOND ❑MOV ING 000NDITIONAL USE [:]DESIGN REVIEW ❑COUNCIL APPRr"QED ❑SIGNS
OCCUPANCY---LAND USE ZONE BLDG.TYPE---FIRE ZONES PLAN CHECK BY HEAT----
b d
EAT .._.__brrd
0SSL4AtLFLSLQA.LQAQ --- .�LrL_I�---- .__N9..SI.S2fi! _._— AREL__—h'SLEE.4�SZM$ Y£�L ___---------
BUILDING DEPARTMENT___j SET SACKS_ FRONT REAR LFFT SIDE RIGHT SIDE
Permit
— — THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CC'':Jt:, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY .GREED TH! ' THE
— WORK WIL.L BE DONE 114 ACCORDANCE WITH THE PLANS O.ND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal ALL APPLICABLE CODES AND ORDINANCES. THE ISS')ANCE OF THIS PERMIY DOES NOF WAIVE
— PESTRICTIVE COVENANTS, CONTRACTOR AND SUd CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State'Tax . LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HFATING.
Total
NY
APPLICANT OR AGFNT
Approved Receipt No }
ADDRESS ----- _._�—.— ---P140N' _—___.L..
1
DATE INSPP, TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
GPermit No.
f(
p — Fixture —_
Final -i -
HEATING
Contractor 7
Permit No.
Gar,or Oil
----- �— Final
SEWER_
Final
_. �--- ------ ----DRIVEWAY....
--- ----------- -------- ��. Final
—— Storm Drainage
(Hain Drain)Final
— � Sidewalk
Curb R Str at Final
Npproach
BLDG. DEPT.FINAL — ~TEMPORARY CBR'I IFICATE OCCUPANCY Final
GEIk !T1:MPOQCCUPAPKY�- ----- -- --- --_._.—_. ------
Lundscaping
Zoning Final
I cl I I,-i W10C lINICL4l V Ci olrlll
Fee
r
N�.. Ir c;�Co:ipn Rv-6ce ❑ Relocation ❑ AdditiOn ❑ AI1Crdtior' Ay t i Cta1a
CONTRACTOR r!' �r��/)� SJ!'J/T/� L�'d/1�S✓ 01'�r.cR - - -
Ap7Rc G�C d s�s� D .0 E�S"o/✓ ef'/� WO ESQ A�46,4A e e v.e r PRe-Cr7
PHONE 3 .7 _ APPLICANT_A,1'rS" A �� C'�J1rD /j l0 V / —
Heat Input Rating (BTU Per kuur)_ r �� Vent Size ` _ Flue Size_
FUEL OIL ❑ GAS ❑ ELECT �'+' OTHER _______,
ITEM NO. FEE ITEM NO. FEE
For Issuance of Permit ��-- 3.00 Air Condition Compressor 15 to 30 HP 10.0(
New• Under 100,000 BTU _ —� ) 4.00 Air Handling 10,00_0 CFM r 3.0
• New• 100,000 BTU &over - 5.00 Air Handling Over 10,00.0 CFM 5.01
Flocr Furnace --.---4.00 Evaporative Cooler �1---�—�_ 3.0(
x= wall - Floor •Suspended 4.00 Range Vent Fan 2.0,
Install Vents Only 2.00 Vent System 3.0(
Repair. Heat & Cooling 4.00 _Hood Commercial _
Air Condition Compressa Under 3 HP 4.0D Commercial Duct Systt:m 0(4\ir Condition Compresso3 to 15HP� 7.50.__.. L43.10(
_._..__a..
' * INSPECTOR'S COMMENTS
CITY BUSINESS LICENSE. REOUIRED FOR ALL CONTRACTORS OR SUP•CONTRACTORS
APPROVED BY- – DATE _-- ISSUED 9Y — _ --- UA E —
:�: RECEIPT NO.
'- 9
Si nature of Appli
»
c , [ N/ o f TgcT(1 Permit__
iard Mechanial Perluit
Fro �D
Nov. 1r1-,,io1:aiion Y Re-.0ace 0 Relocat;un El Addition ID Alteration D yV2' Suite_
CONTRACTOR e-AiK PE ffDjFg r dc+,Oyxr 0'4"NE F.
Ise
ADDRESS_ 4'70 0 0 A/--.&0 Al IC9 WORK AUORESS_ZJA
PHONE 3 7PPLICANI 44� k
— el L) d N Alr7
r7. 7 A' 7 Vent Size
Heat h,put Rating (13TU Per Hour r.o 3 Flue Size
FUEL 011. r1 G AS M E L f l F R
ITEM NO. FEE ITEM NO.
FEE
For Issiance of Permit 3.00 Air_Ecndition Gornpr essor 15 to 30 HP 10.0(
New Under 100,000 BTI,1 4.00 Air Hardl-ng 10,000 CFM
3.00
New- ICIU,UOUBTU& over 6.00 **Air Handling Over 10.000 CFM 5.0
Floor—Fu;n-a-ce- 4.00 Evaporative Cooler 3 00
1 1 . Floor - §Uspencled 4.00 Range Vent Fan
Install Vent, Only
on Vent System 3.00
Hond Commercial 3 01'
Repair - Heat & Cooling
Air Condition Compressor Under 3 HP COMIT19f6al Duc-, §yslern
..,%ir Condition Compf essof 3 to 15 HP
INSPECTOR'S COMIMENTS
UIRED FOR ALL CONTRACTORS OR SUB-CONTRACTORS
CITY BUSINESS LICENJeE0
0
APPROVED RY. DATE ISSUED BY DATE
RECEIPT
laE-
RECEIPT NO.
PERMIT NO.
PER11IT CHARGE none
CONNECTION FEE
'T_!,NER
PAID BY
DATE CONNECTED
iypi: or ouILOING
SERVICE RATE (.Zu d IN5PECTION FEE
7
CONTRACTOR PAID BY DATE
517E OF CONNECTION4, ;5FSSHENT PAID