Laserfiche WebLink
,�.E,.,,,,,, P►PP LI CATIO N FO�d <br /> CONSTRUCTIQN `°"°" <br /> cirr or <br /> �verett PERMIT e <br /> BUILDING DEPARTMENT <br /> 259•8745 TO BE COMPLETED IN INK- PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION O BUILDING �MECHANICAL �PLUMBING ❑ SIGN <br /> OWNER MAILApDi1E55 CIN 21P PHONE <br /> C Lii-RE�a..i7— V�� �..iC� n�cdC, ///o—/U�`_`f�vr /1IE SurrT- j/p �rzr �—I�E �V4 9�Oa¢ <br /> MCHIIECTOR�ESIGNEN M�ILAO�qE55 CILY 21P PNONE <br /> GENEP�LCONfR�GiOR MRILAUORE55 CIfY 21P P��ONE LICENSE• <br /> Cw�1 L'd..isrC.Co. �.o . C�dKl4�8/ t3�Zc.e.v�E Lv�? 9�009 ��9��-'347 <br /> MECII�NIULCONiRAGiOq MiJlR00RE55 CIIV 21P PIIONE �ICENSE• <br /> �WMBINGf�ONIq�G10F , M�ILADORE55 ClIY 21P PIIONE . IICENSE• <br /> ltil��T tif��N•wrucl.uC. 9630-/53'��da n,E R�,,,�d,�� Wd ?20Sy 8Y3-9tz¢ ver.ir•�ur/5��,.. <br /> Cu550F WORk � <br /> ❑ NEW (�AODITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSER- ❑ BUILDING RELOCATION <br /> WW IIONOF ORN�GOSiOfM�IERIRL5PW5LRBONI — <br /> �'�� � �O ,O G <br /> OESCPi9E WORR � <br /> /� � I <br /> Ij D()��'/� /}'rt1� /N S�'LL /1 Q��1-� I N /L'K�fiJ% ,�/J S jl:l i_L Z �D a F -� 74� <br /> 1�J S/�C� G A'S E LtC u� r 7-� <br /> useorewiou+c , � <br /> �<_"7'N �C- Cpw.H CkC�� L I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> PLICATION AND KNOW THE SAME TO BETRUE AND CORRECT.A�l <br /> IEG�LDESCRiPT10NOFPROPERIY�SHONNBELOWORAi1AC11FOtIRCOPIES� pROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPE <br /> OF WC7K WILL BE COMPLETED'VJITH WHETHEFi SPECIFIED HERE- <br /> ioi_eioc�_oF IN Ofi PIOT.THE GRANTING OFA PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHQRITY TO VIOLATE OR CANCEI THE PROVISIONS OF <br /> ANYOTHER STAiE OR LOCAL LA\Y REGULATING CONSTRUCTION <br /> OR TNE PERFORMANCE OF CONSTRUCTION. <br /> SIGNATUHE O 'ONTRACTOP O`��H�RIZED AGF�NT DATE <br /> X �� � • c��.._C -���. .,. �� I3� I � . <br /> PHOJEC�T�DD9ESS AFPLI NTS I�YBUSINESSLICENSENO /�, <br /> � / / / G�'GnC�t� � V��r(1^ <br /> PLUMBINQ MECHANICAL <br /> NO. 7YPE OF FIXTURE FEE NO. TYPE OF EOUIPMENT FEE <br /> WATERCLOSET�TOILET) Q � '}-. AIflCOND. UNITS-H.P.EA. �j• <br /> BATFiTU9 REFRIGERATION UNITS-H.P.EA. <br /> LAVAiORY�WASHBASIN� OJ BOILEFS-H.P.EA. <br /> SHOWER GFS FIRED AC.UNITS-TONNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCEO AIR SYSTEMS-B.T.U. M EA. <br /> OISHWASHER WALL HEATEFS-O.T.U. M <br /> LAUNDRYTRAY UNITHEAIERS-B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WA7ER HEATER CLOTHES ORVERS <br /> UHINAL I VENTII.ATIONFAN 7d�CCi OG/�+�. <br /> ORINKING FOUNTAIN RANGE HOO� <br /> FLOOR ORAIN AIR HANDLING UNIT- C.F.M. <br /> VACUUM BREANERS STOVE <br /> FOOF DRAINS-pAINLEADERS METAL FIREPLACE 8 CHIMNEY <br /> SINKISERVICE-BAR.ETC. WOODSiOVE/FIREPLAC INSERT <br /> SUB TOTAL / SUH TOTAL 3 <br /> PERMIT S PERMIT <br /> _ TOTALFEE S TOTALFEE <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> FqON15EIBBCN FE4NSEi6RCK SIDESEiB4CN PLANCHEGKNUMBER PUNCHECNiEE <br /> FEE REGEIPINO <br /> USE20NE �OfAREA <br /> VFCANTSITE FEES VALUATION FEE <br /> OYES ONO <br /> ttFEOFCONSi. OLGUPANLYGNOUP NO.OFDWELLINGUNITS <br /> BUILOIPIQ S <br /> S12EOFBL00 NO.OFSTORIES MA%.00GlOAO <br /> PLUMDINC Q <br /> MFCHANICAL <br /> FIRE SPRINKIERS fiEOUIRED ❑ VES ❑ NO <br /> OTHER <br /> PENALTY <br /> RPPl1UIlON ACC BY P�pNS CMECKED BY RPPq.FOB ISSUPNCE BY � � _ <br /> � I TOTAL <br /> L I/1 <br /> CtiR`l <br />