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r,fmil ISO. 017Y OF MOUNDS VIEW <br />_A_L-)I �, BUILDING <br />Af-PUC AI I N <br />),� <br />/ - � L (. /\ � <br />F numhPrfd eCeCHT: r/I• <br />i� <br />�.�L�U(Ipfj� <br />\hlFirlP n �w�•.rr.n•,.rr •+�eveZ�ll. <br />s' �.:.3L7Jw'fC: d:G.�..L•"C'��-CtIi�QPf� <br />• <br />M1 r, <br />3 <br />•Pfn RN DHH.ee mn .Do.U+ <br />I,U+IP <br />••D+t <br />Q <br />lap <br />n <br />5 Class of work: ❑NEW LVADDITION DALTERATION <br />RREPAIn ❑MOVE :IIEMOVE <br />a <br />6 OeeDlbe work: ; Y 1 i - n, <br />it 'l.il(l\: DY / h�;:,i7•('t/:+., In ,f. •;r':.�I. , •.. :+. <br />�) <br />,�+, <br />_ 1 , w�'I t.__ I ri n( ri • F,:�.�1__+� d .I _.-.__•t. :r.;•,/ � <br />Ch•nge of uee [IBM <br />—�--1 <br />`� nn <br />rhengeRlulttB � ec" rllii•:• <br />' / ( <br />li�iul,N ,P <br />.!.IJ -t:•7LT,J{� <br />_•r�ryTl)I^ <br />_—_— „ <br />7 VilustlanIIIwail.S <br />Ir em <br />Dtt:,duvy •' <br />J <br />I <br />�/• �: (i( <br />Canl <br />GInuP <br />Umuon <br />5.1N el Biat Nn nI <br />Mi. <br />NOTICE <br />;TKNR so FI Snnn <br />Ou Law <br />�THE PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUE <br />TION AUTHORI2CO IS NOT COMMENCED WITHIN 120 DAYS. OR <br />F•r+ us <br />ZnnN L°•t <br />F,H SDHnLNH <br />Reouuea ❑vH ❑Na <br />IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED <br />•I FOR A PERIOD OF 120 DAYS AT ANY TIMF AFTER WORK IS <br />—'-- —' <br />Nn �•I UFISTREET PARKING SPACES <br />COMMENCED. <br />D.m.ae U,R+ Cn""d <br />I uI•rovene <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />nPPLICATION AND KNOW THE SAME TO BE TRUE AND COR nECT. <br />ut' W <br />um <br />Lot ,e <br />ALL PROVISIONS OF LAWS AND OIIDINANL ES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH wNEi1gR SPEC If IED <br />Hrt•. <br />HEREIN On NOT. THE GRANTING OF A PE RANT DOES NOT <br />Pn L.uCeC COVE V LATE R EL <br />_ <br />SP•ea16+: o+nvaB I Rrnu,nd Ren,vetl Nm R..•,,,..A <br />PROVISIONS OF ANY OTHER STATE OR LOCAL LAID <br />CONSTRUCTION OR THE PERFORMANCE OF C <br />ZOlI I1eG-- <br />� <br />HEALTH OCPT <br />Lri..rW10I tOnrL•ItP, P, •uruPalD •f Nl <br />FIRE DEPT <br />SOIL REPORT <br />OTHER ISDIC-10 <br />I:i^. ;::_C•1'•O.nl•N•nPIP���SPECIAL <br />CONDITIONS <br />TO APPLICANT PLEAT. <br />ee CLIMPORTANT <br />SEPERATE PERMITS REQUIRED <br />PLUMBING q...uc.uaHEATING, VENTILATING�eT�u-,7o-13I <br />OR AIR CONDITIONING M <br />I <br />YT(�-• <br />ELECTRICAL N <br />BLACKTOPPING <br />CONTRACTORS LICENSE yes <br />no err <br />SEWER II rr WATERO— <br />PERMIT FEE <br />S p <br />THIS IS AN APPLICATION ONLY <br />PLAN CHECK FEE <br />_ <br />p <br />e" L THE PERMIT 47ILI, BE ISSUED AFTER <br />_ SURCHARGE <br />�- - <br />s.DM.cllnncE <br />—_ <br />RL•'VIEWAL OF THE APPLICATION. <br />TOTALFEE <br />i� • ii�o•$�' <br />l'l 3o `� <br />