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THIS APT'Z,JCANT IS:
From: 6519948701
Page: 1/4 Date: 4/12/2011 7:47:04 AM
PL{��VIBING Pernn,i.t No.: ��
RES����+'1�T�,A�.L AP�'LICA.�"IUN Recei.ved �y:
CI'�'Y CaF F�IDL��' ��f��p�: A� R 2���
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p OVJNF,R �C1NT�CTUR
PROP�RTY ��;
O'WNER/ q15i7RESS: CiTY _ --STATE 7IP
TENANT
SUF3�VI.IT A C�P�C (�F $TATE LICEN3�l1_
YqUR STATE
LICENS}:, BOND AND sTATE S�M7 #�
CEILTTFICATE 0�' nD��rtE55: ,� �..,
11V5URANC� P��� � �% • �
PERN�T�' TYPE �'smtG[.� xntv�.�t
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oETa�.��a n�sc���rt o� wo�tx ��'-�
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:J � �'�. ���� l f1 fiXP DATE `° ` .� %.�
�xF nn'��1 _ I � '�� .� `&
r�� �%� �� l` f�� CJTY/j���1L'd�L r� '? f�-3TAT1L�/'I
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FEHS ARE BA3ED ON �1D.D0 PER FLXTUR�, EJi�N',.P'1' WFiSRE NOTED. FIJ�'Lf1tEfi: (INDICATE TOTAI. NUM$F..R OF EACF3 DELOW}, MINIMUM F�E
�50.
BATH 91NKI�:.AV _FZl7C]� 1)RAWS SHOWLR _ WATT� PTPINIG
� BATHTUB C3AS PII'I�TG {N�FD CITY LIG� � SW�MMING POOL WATER SOPTN�IZ (S35}
CI,p'ifT�S WASHER � TCYTCHEIV SINK � WATER C,i,ps�?'C _$ACKFLOW PREV. (S ] 5)
DI3FiWA3l-�Z LAIJNf?!�'Y TRAY WATER Ii�ATIIZ ($35) POR IRRIGAT.T,ON
� � WAT'�l.i MF'TFR 0'�'HBR
�rFUS �9 �r �r�.�c,a�
I hereby apply for a plumbing permi Z acknrn
conformanc� with the ardinances and cvd the
not a pe[m+t hut pnly an. application far a_� i�
with the appraved plan .int t�e� ,� e of �l! �4
SIaNATUR� OF Ak�'LJGt1N�' J�l` �Ilti�s!-1 � .
I FOR /�1 FERMIT-I3C�"f V ALEE71. JNT'Cl, PROCESSED
th�t ttre informatian above is cona�lete and accurate; that the work will be in
af Fridiey and witk� tlae Mir�ne�trta Gonsiruction Codes; Chttt I understand this ia
work is nat ta start witho�t a permit on site; that t.�e woxk wiil be in aocordance
��res revie�u and app�ov of p(ans, � +
,,�I'RI1VT �Il�Iv.iF.. ��C,IATE �,� � I � � � r
�`'�� �1% Of �'CMt���y
Xiu�lding In�pections Department
643I Universi�y Avenu� 1�, ��idley, NT,.� SSq�32
763-572-36Q4
FAX� 7�i3-Sb2-4977