Laserfiche WebLink
� <br /> r ,�i^.PPLICATION FOL'a everen <br /> I�sEvaiD��^ CO N ST R U CT I O N � <br /> GITY OF <br /> eve_rett PERMIT <br /> TO BE COMPLETED IN BLACK INK- PLEASE PRINT <br /> BUILDING DEPT. <br /> 259•8745 ❑ COMBINATION ❑ BUILDING ❑ Ni�CHANICAL ❑ PLUMBING ❑ SIGN <br /> PHONE <br /> OWNEA r MPIL/RDOf1E55 � •�'^' �P �'C,C/� -� <br /> CJ '`17 / / � � � Q' '1 �.. ��v�i�i�niY�sCATi CF wA Lnca'i✓tr �.lc✓y G1/• /1.�/ <br /> ��M�IL AODP.SS GITY 21P PN E — <br /> RHCY.IiECiORUE5IG��ER / _ �/19�f�Qp� J��'� ��r � <br /> '" � � �I (/ <br /> C_.'7 ^Qrl' CIiY .F.dQNE LI [• <br /> GENE(1nLGON1PRCTOH MAIL��ORES �U,�-rAc� <br /> 1 q <br /> �� �II L/I^ CITy 21P PHONE LICENSE• <br /> MECIIANIC�LCONTfUCtOfI MRIL�0�11E55 <br /> PLUMBINOCONiR�GTON MRILA�D�ESS <br /> CIiY ZIP PHONE LIGENSE• <br /> GL�SS OF WORN <br /> ❑ NEW ❑ ADDITION � ALTEfiATIt7N ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.IN:iERT BUILDING RELOCA710N Z <br /> O <br /> W L W t�ON OF W OBN(GOST OF MR�ENIPLS PW 5 LnBOR� � <br /> i--i <br /> '�:���OD m <br /> oescnieewonn � �U � ,p � <• Q � GI hll. �7� ual '• <br /> ^� ,1� ���-� G�i� ��lLE(�v1•/ - l�c�i�io� . 5. � o <br /> use ew�ov+c. �� ^ . �' `,- . �� I HEREBY CERTIFY THAT I HAVE F1EAD AND EXAMINED THIS AP- � T <br /> � ��%_���;'}° . �%���� ,�. c-r'G�!•%'��� PLICATIONANDKNOWTHESAMET08ETRUEANDCORRECT.ALL � � <br /> LE6�L/D'ESCHIPTION OF PPOPEPLY�SIIOWN BEIOW ORATTACH FOIIFGO�E57 OF WORY�.WILOL BE COMPLE ED WITH WHETHOER SPEC FIED HERE- N fTl <br /> �or�o�oc�oF ��U�'�� � ��/ ��d��'�an /� ��'l �� �NORNOT.THEGRANTINGOFAPERMITDOESNOTPRESUMETO <br /> , GIVE AUTHORITY TO VIOLATE OR CANCEL 7HE PROVISIONS O� m o <br /> / iJ J � � .�I ! �I ' ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCT�ON n <br /> •7 �� 4� 7 S �= ' /'�y- "r ��'r- W ��� OR THE PERFORMANCE OF CONSTRUCTION. o m <br /> ' � /�i�� I I SIGNATURE OF CONTRA it OR AU�RI2E0 AGENT DATE _� <br /> ( It�1Lt.✓ /,�� � C 'f� C-��Q � / , m <br /> �j .-i <br /> / �J . i � . J r"�O /� v G.II�!/ �' . . ,. � ..c! ! % O .r7 .O Z <br /> 3 � CU �/ �+ L"_�LI�i/b - ' p �NTSCITVBVSINE59i10EN5ENQ✓ <br /> D —I <br /> vno�ecr�ooness �y .:.a:a�/�c � �,rs' � C�-'« �✓'f t' / /�° r x <br /> � ' ere'�'!� (..�I� � -1 N <br /> 5-' �'� /' U['�:� '�- �"� ` <br /> � MECHANICAL � <br /> pLUMBIN6 7ypE OF EOUIPMENT FEE � 3 <br /> TYFE OF FIXTUflE FEE NO. <br /> NO. �j AIR COND.UNITS-H.P.EA. -� T <br /> WATER CLOSET�TOILET) _ <br /> HEFRIGERATION UNITS-H.P.EA. n1 r+ <br /> BAiIITUB _ N <br /> BOIIERS-H.P.EA. O <br /> �_ LAVATORVIWASH9ASIW � <br /> GAS FIRED AC.UNITS-TONNFGE EA n m <br /> SHOWER C N <br /> KI7CHEN SINH 8 DISP. FORCED��R SVS7EMS-B.T.U. M EA 3 � <br /> DISHWASHER WALLHEA7ER5-B.T.U. M , Zn <br /> UNITHEPTERS-B.T.U. M --Im <br /> LAUNOPVTRAV y <br /> CLOTHES WASfI[R EVAPOF7ATIVE COOLERS — <br /> CLOTHES DRYERS A <br /> WAiER NEATER "'� <br /> VEN�ILAiION FAN = <br /> Ui71NAL RANGE HOOD Z <br /> ORINKING FOUNTAIN <br /> FLOOR�RAIN AIR HANDLING UNIT- C.F.M. � <br /> STOVE ,._., <br /> VACUUM BREAKERS N <br /> ROOF DAAINS-RAINLEADERS METAL FIHEPLACE 8 CHIMNEV <br /> WOO�STOVE/FIREPLPCEINSERT Z <br /> SINKISER`�ICE-BAR,ETC. � <br /> 1 <br /> — n <br /> m <br /> SUBTOTAL s <br /> SU9 TOTAL pEHMIT 5 � <br /> 3 <br /> PERMIT TOTALFEE S <br /> TOTALFEE s <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> P�AN CIIECN NUM9ER PLAN CIIECN GEE <br /> FRONt5E1BACK REARSE1tlRCN SIDESETpACK � / �EE Qf RECEIP. 0�� � <br /> . - - N. q. - � rY�� 3 yU- <br /> USE ZONE L01�REF ypC4NT SITE FEES VALUAT:ON FEE <br /> /.��.Z' N� , OVES �NO <br /> /7 Z.�1 <br /> TYPEOF�CONST. OCGUPAN�[C�'YGROUP NO.OFOWELIulGUNIiS ��y� /J <br /> -'� !� /rJ�Z- � BIIILDING 5�[�L.(J, L � <br /> Jt—' <br /> SRE OF OLOO�O � NO.Of Sf�IES NAK OCG LUAD �� <br /> . 7 / f � �3/ PLUM91N0 <br /> f� <br /> MECHANICAL �O <br /> FIRE SPRINKLERS REOUIRED ❑YES NO OTMER <br /> PENAITY <br /> RPPLICFTIONACC.�Y PLANSGIIECKEDUY APPR fORI55UANGE�Y — /J/1� <br /> � IOTAL 'U'6 <br /> ��� ���� � <br /> � � �✓ <br />