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P - 42337From: 7635193932 Page: 1/2 Date: 7/19/2010 7:23:44 AM Bu�,i�,y.rig ��,,��(�. Permit �1a.: � U jU Inspections C01V1N��+ �.��.A►.L A�'�.'LICATIIaN �.ecexved �y: � j�' j �63-s�2-3�04 CITY UF F�I,D�,�� ate �te�'�t: ��-soa-�� '� r:rr-EC:l1vr, a-l-2ol0 I�A�CE ("( GI' I U YOETtt �IrL4¢, ADDRF3S • 5rf� ApD�tESS f i�t7 � �� i�.� l4-� ��' ,, _ TEIdANT S1A'P� N(7. PROPER7 Y rr.�� (Y��.1 "� ow�R� ,�nn�ss: �'�,�Y��ael�� ci� � t� I�� ,_ STA7'F�IP�,% '�NANT P�ON�: ~� � I� � ~%�% � `� -� co�r�,cyra�x ,�,�: -#�,r- � r Y SUBNIIY A COPX OF s�.nz� �,�c�s� a�3 $��f 1 f'�-7 � nn-� �/—!C� vvv� sr�.r� ��5�, �o� � �.�,��G �o,� � r b � � � � � k� AA� CERTIFIC:ATE OF avUxras: f`-�F S�� c� '1 !'� �� i+� �r�x �' 1�cm -��a� sT�� zr��5 Y� INSURANC� PIiONE � fd .3� S�,7 •-�� O�} ,, FAX I.�p �� 1'rJ t 7�1 r� �� r PE��' �'YPE � it�FS717v'c1oNAL ❑ t�vWrt k,9,MaF.x I3 swiMlvv�IG P�ot � I'OWPIIi�7U3S {7 COMhIEItC[ALfIF�iDUSTRIAL q diAiER �X�� Cik' W'Q�: G7 NEW T�FitEFLACEN�Nf 0�U.��LA.'�'iON/REMODEL DETAILED DESCRiFT70N OF WORiC ��C:�Ct,�° L� GiS (J'.'i f.e..-'F d r� �°( �e..� �P' �' �y ]'YIYYI€' f`G LC._.I �, . FIX'I'[JRES: (IIJDFCATE TOTAI, NUMBER OF EACf� _ CI.0��5 W,AS�Ft _ FLQC1�t ARA@IS _ RPZ VALVE `LJ�N,A,[, _�.1xS�GVA9kt�R _GA$PIPING HACICFLOWPREV. �WA,"�'ERil�A7'ESt DitIIVKI1VG FOUNIAIIV _ L'rREASE TRAP _„ ROOF p�IA7S � WATER ME7ER FAt1C�'i ' _1Gd�'C�E�i5�1�C _3�iOWER `VYAT�Tit�1G _FLAMt�dABl.� WA$lE TANK ,�LA[1NT3RX T�tAY _Sd.Ok S�t�C _ WAT�R SOkT�� ,,,,w, LAVATOxtX _SW�VG �04L _ WATER C,LQS� Totel Job $��'✓,�� AlI fees ace based an veluet�ioz�, iuxaRuding t1�e oost of labor and matcria�s_ Vst�u�r�ta� �eirKttiit Fee $ ~%.� � i� (I .25% of Job Valuation / Mi�n,iz�u�c� f,�: S3S Swc�arge S e2 ,'�3 Valuation X.0005 or Mi�umurn .50 � �-- To�l Due � �J` �Q Make G'�ecks �'ayabic to: Caty o� ��dley THIS IS AN dPt►LICATION FOR A P�K14�IT �TQ� VA,I,dA (J�TTi�, p�tpC�gS�i Z��Y apPh' for a plumbing permit ead I aaknowledge that tho inforn�a�oa sbove is cxm�p�ete s�nci accurate; that the w�ic w�l bc in confozmance with the or�inances end codes uf the City af �ridaey and wi�tb tt�e �iuouaes�ka Ca�astraction Codes; that I understand thi� is nat a ps�n.it but only aa application f� � pernut and work is not to sta�t witb�oui a pefr�ai�t on sxtt; that the woric will be in accordence with the approved plsn in the case o�s]{ wark �ich nequices �eview at�d a�p�royal af plans. NAME �� A,PP'I.I'C,A,�i'�' p� f_.P�1� d�a L+. f+�. DATE 'f �„ 1 C'� "' 1 C7 S]G�VA'xU�tb O� ,A.��,I�ANT t' ''� &�--�,-.� . PLEAS� �TO�E: S��,A�,.A,'� ��'S A,� RE LTYR�T3 FOR SUII,DING ELEG'TRICAL A�3D MECHANICA�. WOTtK �[:;ty o� k'anid�ey �wild'uig Ins�ec#ions Departno�eJUt 643I University Avenue �1E, k'�id�ey, �N SS432 763•572-3604 k',A.�: 763-502-4977