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EACH TOTALil4"""""0", I
<br />"arstriet
<br />E comm.rciat r{o.
<br />FIXTURES
<br />JOBADDsESS
<br />9+Y-t3(2_-2r/*6 4.00each plumbing fixture/trap
<br />(-/
<br />10.00Oontal Unit or MedicalGas€s
<br />SEWER
<br />10.00lst 100' + Conn
<br />3.00Ea Add'lConn
<br />3.00Ea. Add'l 100'or Fraction
<br />30.00Private Sewage Disp. System
<br />GAS PIPING
<br />5.00GASSERVICE 1 ro 4 Ourlets
<br />1.00Ea. Add'lOutlet
<br />20.00T€mporary GasService
<br />MISCELLANEOUS
<br />(}Il|--8dd.rM.l
<br />I h.l!b! lrrhn $d Lm .r6mpr lrom ltls Co.$acrof3 Li6.s L.w lor tho lollowing rden lse.
<br />7031.5, Bu.lr'.3r ..'d ProLrlih! C.d.: Any oiy or co'rnly which 6qui63 t p.rhil to co.rlttucl,
<br />lltlr. imo.o'.. rhholi.h, o. l!o.t .nv $ructuG, p.id lo il! isane. !l5o Gquire. rhe lpplic&l ld
<br />'rl p.mn b fl. r nlnod .r.t m6nt thlt h€ is licsns.d ptr6oDl lo t16 proenoru ot itB Cmt*_
<br />to.'. Ljcons L.w {Ch.trd I lcmmei.g wih S.cIifi Tmol ol Dividm 3 o, tho B{$n.$ end
<br />Prsl.lliro Co.hl d lh.t h. it .xompl li€.llldn .nd lho b.!i3lor lh. !ll6!Ed .r6mprio.r. Art viol&
<br />ton ol S.crb. 703r.6 by .ny .pd'c!.t tor , p.nar arbiecl! ih. 6poli@.t lo . .M p.n.lv ol nol
<br />mo.. th.n liE h0.d6d d,olhls I asOO):
<br />! S"a,on ZO.l,ol l, !.o*mr oftn6 p.op6rty, or hy oholoyess wlh w.o.saslh€ sol6 com'
<br />o.nsrid, will .k rh. wqk, .nd rhs lltuctu.s is nol ,nbn&d or otl.Bd lor 3.16.
<br />E S*ri- U OalA l, .! oem.r ol th. po?..|y, .m 6xcrusivolY co.lrscri.C with licon$d @n_
<br />racto.r lo @Nltlcl th. projEr
<br />D.,. O*mrrs{ r
<br />-
<br />STATE/ZIPCITY
<br />C
<br />5.00Wat6r Heater Eloctric orGas
<br />Cooir.cto. Ur. Only 4.00Water Pipinq Ea. 10O'PHONE
<br />$t -t ot 1s
<br />CONTRACTOR
<br />4.00Bain Water Piping (buried) Ea. 1OO'
<br />4.00Water Sottener
<br />?-3 Sa-z.. '&ov.--rllj t)< .w 't
<br />Alt. or R6pairot Drainag€ -Vent PipingCITY
<br />t--fr,...)- ^ l-|r -._o
<br />t olr,r9 >oi3*3.OOL,awn Sprinkler
<br />4.00Rain System - Por Drain (inside)
<br />8.00lnd. Waste lnterceotor
<br />5.00PoolTraps
<br />3oo IIRoof Drain Systom - P€. Drain
<br />3.00F€pair/Alt. Drainage or Vent
<br />5.00Vacuum Breekers 1-5
<br />1.00Over 5
<br />5.00BacHlow Devico 2" or Less
<br />10.00Ovet 2"
<br />i.\\
<br />Waler Service
<br />RE
<br />-
<br />o.ov'soDsol Ch.ord 9 D'v'eoo 3 ollh. Bu3'ns3!3.d
<br />;." {rfu"a-rt< . rarl- 0{A
<br />tryori-. Cor|rp.lr..tlon o.dr.don
<br />I hs.sby.tl.m tn.r I h€w ! @nifE.|' ol coh!.nr ro $lt-in3ur6, q ! c.nilicao ol l4b*sr'3 comp.n_
<br />l6niiy thlr n $o O.rtomem6 ot tho wol( ld which lhB p€rmrl is issu€d, I shall ^ol omploy 6ny
<br />p.rso i. 6ny m6h@r e sr ro b.come sub,ocr ro rh6 wb.r.r's comp€n*ion L3ws ot cBlildni.
<br />Y
<br />(
<br />I h..&y.flim U.rl.m lic.n*d und6. lh6
<br />Po'6s@ f lzrt9qey Xonre€+'I -r-'z
<br />4l
<br />Subtotal
<br />'--"rar$
<br />eY "riru,E^wpl
<br />_r" ,wopfCI/Oi.
<br />Penalty Fee (when applicable)
<br />Violation Fee (mlnlmum t35.OO)
<br />Plan Check Fee (minimum $t5.OO)Accl.* 1 1-402
<br />Bece pt No No.
<br />10.00lssuance Fee
<br />314TOTAL PEnMIT FEE (rnlnimum l35.Oo)
<br />PERMlr o. 58 /4o^fE li -/h*t
<br />ExPhort
<br />Thl! Fmir !h!ll.xri.. by limitltim .nd b6com. nlll .dd wid it lh. rcd .ulhdizod by thit p..mn E
<br />mr c@Nnc.d wibin 180 d.t! iiorn th6 d.r. ol this o€rftt o. wo.t 6!lho,iu.d bv ttB p.mir is
<br />wsp6i{6d o. .5.ndon€d d .nV rim .ft.r rh€ wdt i! cmm.nc.d ld . p..iod ol rAO dly3 A Ew
<br />p.m !nr[ !. obrriNd fi'lr bolo., .uch wqk c.n b6 r@omm6.c.d
<br />A99lclrl'. Ordr.do.r
<br />I @.tly th.r I hrv. 6.d rhis rppli€tio..d 31116 rtul lhe sbos
<br />comD! wirh lll city ddim@! snd 3la1s law3 .sl.t.o ro boildi
<br />un (^'t \ Q-( /*,clnr
<br />q re6nr rsi!
<br />ton is comct I dg.6 to
<br />.iz. l.pr.si.tiw! ol this cily to 6.16. upon lh.
<br />PEfiMITISSUEDBY ISE
<br />3500:b 311S8-siIR 3lcVAUOAIION IOFFICE USE ONLYI
<br />IACCOUNTTll-4121
<br />a | .,r"orsoNrAANA
<br />20 CIVIC CENTER PLAZA
<br />834-4186
<br />APPLICATTQN AND
<br />PLUMBING PERMIT
<br />0A{TYPEWRITE OR PBINT IN INK)
<br />APPLICANT FILL IN BELOW
<br />c
<br />Iz
<br />Distribution: 1. lnsDeclor Copy 2. Fil6Copy 3. Flnonce Copy 4. Applicant Copy
<br />-1
<br />>>3' ,. o^z-
<br />cL-f4<-*+
<br />D.r.- a@lrcan' rSE r
<br />tlodc. To Agglcrrr:
<br />ll. .li6 m.ti.g rhis C..trfE!16 ot Uomprion, you should b.coh. sub,6ct ro fic U,{cltor's Cmpon_
<br />r.ton ,.ovisrons ot rh€ Lsbo. Cod€, y@ hu3l lo.rnwnh .omp1Y wirh such prryEion3 or lhB p€rmh
<br />sh.ll ba rL€m6d rwot.d
<br />Y,*i:;f," z? r21 u,,,,,o ,,*,,,ufu&-
<br />" S1.t tt
<br />3.00
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