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, � � ,���r <br /> CI'I'Y OF QItQNt7 �'�.,ICATI�N Ft�R PLUMBIl�tCx I'ERMIT" <br /> �nx 66 (2750 Kellcy parkway) <br /> C�rystal Be�y, N.�1 S53Z3 ,�,,; . ; :; <br /> G�NFR�A,�,,R�4��T�Q�.�1 <br /> 1. . Yau may apply for pl�unbing permits by �sail or i� �crsoa ac the City offices. <br /> 2. P�rmit cards wili be seai by rcturn mail after a review Is complcted, P�I2IvTXTS A.R� NOT' VALYI� <br /> UN7'IL YpU R�CE1V� A PE�tMIT. �J�2 ,�v„1,�5 ' NOT ��4IN tl T �. THE P�RMIT CARD IS <br /> ,PoS.TF�2�7.�I..�'�iF�.,d4�I�. <br /> 3. Plumbing permits may be issued ONLY to licenstd plurz�bi�� contractors a.nd to property ownors residing <br /> in tha dwclliug. <br /> 4, Wtxcn tury n,aw constructian or remodeling is tnvolvc8, a separate building permit inust be obtained. <br /> 3, All wprk must bc da»� iu accordance with the Statc Cade requirements. <br /> �: All work must be inspected and alr testcd befora it Is covercd. Call 249-4b00. 24-haur notice required. <br /> I�����ns Camplete all items on this ap�lication. Gompute ihe �ermit fee. Sign and date <br /> t�ie certification. YNCOMk'�.�T� APPIICATIONS 'VV�T�..X.. NOT BE PROCESSED. If you have <br /> questians, ca112�9-AbOQ. <br /> Please check one: New _� ___ Addition R�pair � R�place <br /> >C Residenaal Gommercial <br /> �o� srr�',: .3r �� i r�C �.,..�_��. -- -- zip: 5S35U <br /> OwrYer'e N�rte: 1 �'1.�.��.��i�1 Telephone riTumber: <br /> ._... _._. . __ . --- <br /> Mailln� Address: CftY� __ . _-- -- ���� <br /> Contraatoz�'s Name:��:�i.. Tele hone Number: (�i Z-y z�4-?�J(�3 <br /> Ma�in� A.cidress: i2 r?�.�,�n;,,t�.�p_C��i�_ "�>_City: "� Zip: �J 3 7c�-- <br /> �'I�UMBIN� FIX`X"UR�=,���I��UI�� <br /> FIXTURE �SMT 1ST 2ND OTH�R FIXTURE BSMT iST 2ND OTHER <br /> TYPE FL FL TYP� FI, FL <br /> Wattr Closet � � / �Ioar Dralns 3 <br /> I.avatp�y � � 2 Sewcr EJector <br /> $athtub l,��hV �,A� f X.aundry Tray <br /> .�.. .--------� <br /> Showcr � Wa�her � <br /> i�itchrn Sink Z Water Hcater 1 <br /> DiSposdJ Watcr Softencr <br /> blshwashar Wet 8ar � <br /> Siilcaaks Misc (tist) <br />