Laserfiche WebLink
' /:;�:�, PLICAT!(�M FOP.;,�,�, ���.�n � <br /> ,^.E~.°�R^ -�Cp N STft U C T 1 O N "". <br /> C:tt OF . <br /> ev�er�ctt PERMIT ' �. <br /> E3UILDING DEPARTMENT TO BE COMPLETED IN iNK- PLEASE PRINT � ' <br /> 259-8745 � <br /> ❑ DEMOLITiON O COMBINATION ❑ BUILDING ❑ MECHANICAL � PLUMBING �SIGN ;, <br /> OWNEN M�IlA00RE55 Gli'� Z�P OHONE . ` � <br /> �l T�'1 �r4NK Sb/S E✓62c-r�c��+ rNy <br /> �HCNITECiON0E516NEN M�R�D�HE55 GItY ZIP PNONE <br /> OENEMtGONTN/�G!OR MML�ODRE55 G1Y 2iP PNONE LIGENSE�' <br /> �izRM NE�1J INc , PO,bec 526-9 �N�1INwoup 99bYG 776^s43S �9z4�tN��Y7�D <br /> MEGHIINIWLGONTR�CTOfl MAl1�0011E55 GIIY LIP PHONE LIGEHSE�. <br /> I <br /> VIUMBIN6CONfPACTOA � MMIADOPE55 Gltt ZIP PIIONE 4GENSE• <br /> �1�550F WOPK <br /> N�y ❑ pf7DIT10I! ❑ ALTERATION ❑ REPAIR G DEMOLITION ❑ WOODSTOVE/FHPLIIlSERT '❑ BUILDING HELOCATION <br /> V��TION OF WOAK IGOST OF M�1E111�LG PlUSI�BOP1 <br /> $5?�`� A�IoDE �--isn� sie�v Frwa.. E-��[-m �M.� vY 6��H <br /> UESCRIBE WOPI( ^ <br /> 1�57vrt' �1 ) �F /NTT.2iaR I��_ a1,. ..�.,�- 6N <br /> useoFeuaoina � I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> �OMM��� PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALI <br /> lE6�L0E56AIPl10NOFPPOPEHtVI5�1pWN0[IOWON�TfAGHFOURCOFIES� OFWORKWILOLBECOMPLE EDWITHWHET EFSPECFEDHERE- <br /> iot_o�oc�—oF IN OR NOT.THE GRANTING OF A PERMITDOES NOT PRESUME TQ <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> � ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE O�CONSTRUCTION. <br /> �� . SIGNATU E F LONTRACTOH OR�UiHOR¢EO AGENT OATE <br /> X ,, �� . ,�,-,(� —7 �9/�3 <br /> VqOJEGTA0DRE55 � �PPLIC�N SGIiY�U5iNE55lILlNSENO. � <br /> S� i �c�c�u 33/s� <br /> - MECHANICAL <br /> PlUM01NG 7YPE OF EOUIPMENT FEE <br /> N0. � TVPE OF FIXTURE FEE _ NO. o — <br /> WATERCLOSET�TOILET) AIRCOND.UNITS–H.. EA. <br /> flEFRIGERATION UNITS–H.P.EA. , <br /> BIITHTUB <br /> I_AVATORY WASH BASIN OOILERS–H.P.EA. . <br /> G�5 FIRGD'AC.UNITS–TONNAGE EA. <br /> SHuwCP <br /> ' KITCHEN SINK 6 DISP. FORCED AIR S�STEMS–O.T.U. M EA. <br /> � �iSHW�SHER wAIL HEATERS–B.T.U. M <br /> LAUNDRVTRAV UNITHEATEFS–B.T.U. M <br /> CIOTHES WASMER EVAPORATIVE COOlERS — <br /> ' WATER HEATER _ CIOTHE517RVER5 <br /> � VLNTILATION FAN <br /> URINAL <br /> ORINKING FOUNTAIN FIANGE HOOD <br /> AIR HANDLING UNIT– QF.M. <br /> ' FLOON DR�IN _ <br /> VACUUM 9REAKERS � SIO�e � <br /> � ROOF ORAINS–RAINLEADERS ME7AL FIREPLALE 8 CH�MNEY <br /> � SINK SERV�CE–BAR.ETC. `NOODSTOVE/FIREPLACE INSER7 <br /> ' SUB TOTAL s <br /> ' SU6TOTAL f <br /> PEF.#IIT S PERMIT <br /> TOTALFEE 3 TOTALFEE s <br /> THIS PORTION TO BE COMPL�TED BY BUIL.DING DEPT. i'EaSONN�L . .. <br /> PI.�N GHEGH NUAfOER FUN GNEGN FE2 I <br /> ,iNON�SET0/�G1t NE�P6ElB�GIt SICESETDA:N pECE1PTN0. ' <br /> fEE <br /> USE20NE ��T��E� WC�NTSIiE FEES VAW�TION � fE[ <br /> . � . OYES OHO <br /> IYPEOFGOY.ST. • • OGGUP�NGYGOOUP NO.OFDWElLINOUNIfS � <br /> ' FJILOING � s � • ' � <br /> 312EOFBlG0. NOAF5T0111E5 ' MAXOCG.IO�U , . . . . <br /> . . . ' ' . . PLUMDING � <br /> MEGH�NICA'. ' � ' <br /> -'FIRE SPRINKLEPS REOUIPED O YES O NO OTHEn <br /> � ' � � � � PENRLTY ' . . <br /> �- �PPIIG�TION�Lf_BY FLANS CHECNEO BV I1PVR FOR ISSUJJ{{NGE BY <br /> � ' G'1��� TOTAL � _ <br /> . . . . :i � � . � � . . , . . . . <br />