Laserfiche WebLink
cu, <br />•---- W-- <br />Ruc rluW <br />PERMIT APPLICATION <br />COMBINATION • BUILDING • MECHANICAL I PLUMBING <br />LIP PHUNL <br />N LT Z3G/S 7�j "" `jOZp <br />gCHITECI <br />yc/ j��ps� 77G 97�g <br />A UCH OESIUNLN MAIL AOONk SS <br />(HONE <br />/ /Go Nl•v Gr�.+tia (/ / .s viv + 35'zGsz z /GB 9 <br />GENERAL CONT HALT OH MAIL AUUNESS <br />PHONE LICENSE NU. <br />MkC/IANICAL CUNTRACTOR MAIL ADDRESS <br />PHONE - <br />LICENSE NV. <br />a ►LUMtlING CONTRAC 70N MAIL ADDRLSS <br />PHONE <br />LICENSE NV. <br />PERMIT <PCLASSOF WORK <br />❑COMBINATION------ <br />-"-- <br />❑BUILDING'❑PLUMBING ❑NILC14ANICAL <br />❑NEW <br />❑ADDITION ❑ALT EII.I IIIIN ❑IlC 1'N 11 <br />S ❑DEMOLISH <br />❑FENCE ❑SIGN ❑;w IMMRI(; 1.00l- <br />OESCHIOE WORK <br />- <br />Tazrr,/►c� H��Lsic� �% � Fca'z <br />L[c�i�..-��. = fps <br />PROPOSCO USE <br />OTHER PERMITS OR APPCEVALS <br />NF 1•R <br />LEGAL ULSCIIIPTIOOOPknTY )SHOW BELOW OR ATTACH <br />^L'REZONE SPECIAL USE <br />FOUR COPIES) <br />LOT BLOCK_OF <br />#VARIANCE ,� SNORLINE <br />I <br />. <br />S E PA CHECK. LIST REQUIRED <br />iq—YE5 <br />1:1 N O <br />voe ADDnEsS <br />_ i <br />MECHANICAL <br />PLUMBING <br />TYPE OF ENEIIGY <br />NO. TYPE OF EQUIPMENT FEE <br />AIR COND. UNITS-/V. E0. 5_ 1 <br />--� <br />RkTRIGIPnTION <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />ItA1H tll(IS <br />UMIS HP.EA. <br />-- -- - <br />_ ROILER$ H.P. CA. _--------___�_— j <br />fORCEO AIR SY STENS (I. T.0 MEA. —T-- <br />SPACE h WALL HEAVERS - R T.U. T <br />S <br />TAOIHESWASHLIJ <br />I <br />-I WASHERS <br />U IIIN Y.ING FU UNTAINS <br />FI OOH DIIAI:J$ <br />1 <br />KI1(:HIN SINK? AtUISP <br />—SINKS <br />UNIT HEATERS H.T.Id__ <br />1 <br />- <br />IIAH <br />EV nPOHATiV E_C OOL_E NS <br />_�-� <br />II O R DAIN; RMN LEAULFi$ <br />I <br />CLO TIIES URYE nS <br />SHOWW ER BATHS <br />-- <br />_ <br />------ <br />W ENTILATION FAN <br />1 <br />�- <br />- <br />SENVICE SINKS <br />- <br />SUWS - SLWAGE PUMP <br />RANGE HOOD <br />1 <br />URINALS <br />1 <br />____ <br />.AI(i HANDLING UNIT"' C.f.M. <br />I <br />WA7EH CLOSE T$ <br />WATER 14A1E115 - [LE CITUC <br />..._ <br />-'- <br />WA TEH NEATER <br />_. _... ..-____•-_... .. .- <br />FAG BUILT FIREPLACE h CHIMNEY <br />- ' '-- - -- - <br />OAS. SV STEM: NO OP O V TLIr15 <br />--Guni(Jrni -s <br />.. -. -_L__ <br />I <br />+---- <br />T <br />- 1 <br />1 <br />_ <br />WASH BA--_ <br />WASH BASINS - <br />I <br />LAUNDRY 7 RAYS • <br />— <br />SLJn TOTAL <br />PE_BMIT_ S <br />IIIIS PERMIT BECOMES IVLII L AND VOID 11 WUitK OR f.UN3TRUC <br />_ <br />TOTAL FEE <br />TION AUTHORIZED IS NOT COMMENCED \YITHIN 170 OAYr,. OR IF <br />----- <br />WATFR SLRVICL SIZE BLDG. SUPPLY SIZE <br />CUNSTnUCrION OR WOR< I:; SUSP(: NDED Oil ArIANDONEO FOR A <br />PERIOD Of 120 DAYS AT ANY TIME AF TEII IV(InK IS COMMENCLU. <br />1 'JACK 'HkAH TARO Sk )BACK <br />1 HEHEIIY CERTIFY THAT I IIAVE IIEAV AND EXAMINED T111r, AP <br />PLICAI ION AND KNOW TFYE SAME TO IIE TnUE ANC)CCIRNECT. ALL <br />PFIOVISIDNz; OF LAWS AINU ORDINANCES GOVERNING THIS TYPE <br />US! %(1NL LCI AgLA --- -_-' <br />V ACANT ::R L- <br />OF WOHK WILL BE CUMOIIED 1ITI1 W'HETHFIF ;: PFCIFILO HEREIN <br />On NOT, TIIF GRANTING OF A PERMIT DOES NOT PRESUME TOI <br />OYES ONO J <br />GIVE AUTHORITY TO VIOk ArE ON CANCEL TIIE PRLIVISIONS OF <br />ANY OTHER STATIL OR LOCAL LAW IILGULATINL: CONSTIIUCTION <br />7YFE OF CON- OCCUPANCY GROUP NOrJF OWELLI N(;-- <br />OR 711C PE FIFOHMANCE OF CONST RUC71ON <br />UNIT. S <br />SZOBAD G. iJOOF 97OHIES MAXOC LC. <br />� <br />x 7// <br />FIEIZ/)NI 1IA( <br />I <br />SICNATUHEOF CONTRACTOnO AI7H7,7 Nll C)A TE <br />. <br />REUUII/LU 1 <br />❑YES ❑NO' <br />1'L.nN CHI,CK NUMIILR PLAN CIILCK FLL <br />SPLCIAL CONDITIONS. <br />% %�/ NIf EC IIECEIPT NO <br />� <br />_ <br />-/—.—F _ .. <br />FEES VALUATtON_ iF.E _ <br />' <br />BUILDING IP 1 <br />SEFA REVIEW COMPLETE: ® NO <br />❑YES <br />PLHMnIN(I <br />contact Plannlnq depL, <br />MLCHANICAL <br />1 <br />OTIIER I <br />FPIICAl1UN A111111U Y• fy14)lN1lt1U YT AIIYU\IR UN(1 YY <br />i <br />PENALTY SEC. 7001Y) <br />TOTAL <br />