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l'� � � i <br /> '��►PPLICATION FGt� � <br /> ev� <br />�:a�'"" CONSTRUCTION <br /> �verett PERMIT <br /> TO BE COMPLEIED IN BLACK INK—PLEASE PRINT <br /> UILDINO DEPT. <br /> 59-8745 ❑ COMBtNAT10N ❑ BUILDING ❑ MECHANICAL ❑ PLUMBIN4 ❑ BION <br /> �� M�IIADDl1E!! GfV Z�P �OME <br /> �a..Y�[� ,� yu= 5v�7^'�5�-5���—��� �ur�Tl' ��/ �'3'7 9r�3 <br /> .MIt[Lt 0�10[lIOM[ MML GDOIIElS CITY 1 2M �IONE <br /> �G� ��-��731.—��L.`zr�'�i Dµ A� t�� 98�9'1 �33`f_�'�'7���c����� � <br /> �ntee�cwne�cro� <br /> ����oonee cirr "� ziv rHONa e�s-F+�'M���- <br /> '��������i �,1Ml�OD11E ! C�TY iP PHp4E UCEMlC• � <br /> UMlMO COr11MGlp1 MaL�ODnEB! Cltt IIP PI�ONE LICENBE• <br /> ]�eNEW � ADDI710N 11'J AL1ERAl10N ❑ REPAIR ❑ DEMOLI110N ❑ WOOD9TO�F/FRPLINSERT ❑ BUILDINO RELOCI1ilON <br /> non M wo1�R ICOS�oI MMEmnI!I'lue L�soAl <br /> ��� S <br /> �w �' vcalls��eacs .�r_�Lrr.c.. <br /> si rn e�noMo I IiEREBY CERTIFV TI1AT 1 I1AVF READ AND EXAMINED THI9 AP• <br /> tl��. PLICATION AND KNOW THE SAME TO BE TF7UE AND CORRECT.ALL <br /> m � escm'r NOfIR RI�1lHOWNeELOWOR�T111CNfWf1COME4 pqOVI51CN80FLAWSANOORDINANCE800VERNINOTHI9TYPE <br /> OF WORK WILL BE COMPIETED WI1H WHETIiEH SPECIFIED HEAE• <br /> ��_M��_oi IN OR NOT.THE GRANTINa OF A PERMIT DOES NOT PRESUME 10 <br /> ANVO HERSTIA7EORLOCALLAWREGULATIN6CONSTHUCTION <br /> Ofi THE PERFORMANCE OF CONSTFUCTION. <br /> SION�IUAEOfCONf11 10f70RAVT110N2ED�0ENt U�IE <br /> C� �/.2 7�/'r <br /> ,�ea_ <br /> �04GI�ODRE85 e19'L�C BCt' . GENSEMO. ' <br /> ��a d' .-�9a3 ��G�� � Yz � <br /> tUMlINO MECHIINICIIL __ <br /> /p, S7PE OP FlRTUIIE _ _ FE8 NO. iYPE OF EOU�PMENT FEE <br /> WIITERCL09E1�IO�LEIj _ AIRCOND.UNIT'a-/I.P.EA. <br /> D�TNtU! _ _ REff110ER�TIDNUNIB-H.P.El1. <br /> L�VI1T011Y WI1SH BI151N1 __ BOILERS-H.P.E�. <br /> — 911O�q _ _ pA5 Frt1E0 AC.UNI78-TONNAOE EA <br /> KITCHEN 91NK�DISP. _ FO�CEO�IR 9r3TEM9-B.7.U. M EI1. <br /> DISNN019HER � _ WA�LNEAlER9-B.t.U. M <br /> L�UNORY iR11Y _ UNIT HE�TEAS-P.T.U. M <br /> CLOIHES W�S��EN _ EVAPOA�INE COOLER9 <br /> WATEiI HEAlEl7 ClOf11E9 OA:'ER9 <br /> UMN11L _ VENfIL�110N P�N - <br /> bA�NKINO fOUHIMN _ RANOE HOOD -- <br /> J FIOOR DR�IN _ MR NANOLINO UNIT- QF.M. — <br /> WICUUM BREIIKE�S _ S10VE <br /> qppF DM�NS-RIIINLGUEf79 ME1AL fIREPL�CEB CHIMNEY <br /> 9�N1( SERVICE-BI1R,EtC. WOOD9TOVE/FIAEPUCE INSEHi — <br /> 9UB 70111L !U!I 10TI1L � — <br /> PEIIMIT t CERMIT � <br /> i01p1 FEE • t01J1i FEE • <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> NONIlE1b�Ck �E�nSP.�n/�C✓. 910E9E1B�CK 1'I.�NCNECRNU�ABEN �NCNF.CHfEE <br /> — • '• � V(O�S � IEE !� � RE�E�p�NO __ <br /> 'J 3 <br /> 1lELONE 10������ V�CnNI40F. �EES V�LWt10N iE[ <br /> N�A� nYE3�NO <br /> M1PEOfC011]t IX:ROI'��ICYG/IfI011n� IIO.OFDWCU-INOONIIB }� -��j� <br /> �/� A�'� I„7�/.. O BUILDINO s /✓ O� (J 7a/ <br /> ;AE O!!I(OA. NO O!91pN[S M/X Of.LOAp <br /> ./_ �/, �� � � � IZ PLUMBINQ _ <br /> 'ro �r <br /> � MECHANICIIL <br /> �IRE SPfiINKLEf75 REOUIRED YE9 O NO <br /> OTHER <br /> i'ENIILTY , <br /> :rrueenoe��Ce ar R���3CIIECNEDBY �P�0.f01119f1VMiCEBY � <br /> 10TAL <br /> , . . , - - S. r � . . i . . <br />