Laserfiche WebLink
. <br /> ;�riPQLICATION FOl`}�`: �//�`�1�� �,e� <br /> '��"�°""' CONSTRUCTION y'��'" + <br /> ever�ett PERMIT ��� � 31� `� � <br /> BUILDING DEPARTMENT <br /> 259-8745 TO BE COMPLETED IN INK- PLEASE PRINT <br /> ❑ DEMOLITION � ^OMBINATION ❑ BUILDING . 0 MECHANICAL ❑ PWMBING ❑SICiN <br /> pNNEN MAIL�ODHESS CITY ZIP PHONE <br /> ��/�}Jfc LAhIE �`l02 Izl1Gk�2 �V�LET't" ��'co( 252-215"T <br /> ASCNITE�:1'OflGr.9iONEN M�IL�DORE39 Gltt 21P PHONE . <br /> .��i�l._:r�.y AQc.�� eo - � •r_ ��v3zoG Z58-C�I�')( <br /> . ���; ,. . f 1 � � <br /> � t ,.k'RA(�TUP �IL �ORE59 CITY 21P PHONE LICEN7E• <br /> �,�. . .. :.i"� r <br /> MECXSuriCILLGONiMCTOR nILADORE55 CITY 21P ��,I,GN������EN • <br /> YVl✓ <br /> PLUWINOGONTMCTOR MAILADOPESS GITY 2iF PHONE IICENSE• <br /> CL�SBOF WOfIN <br /> I� NEW ❑ ADOITION ❑ ALTEHATION ❑ REPAIIi ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDIN6 RELOCATION <br /> VALWTION OI M�011K�GOlT OF M�TERULS VLUS IABOPo � <br /> � �� � <br /> p[lCII1�E WOIIK <br /> 2 o P�1,' �u <br /> uscawaonw � I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP <br /> .A 1'rp ALES J� Sr`�l�C� CRlJ—j� p�ICATIONANDKNOWTHESAMETOBETRUEANDCORRECLALL <br /> lLO LDFiCMIf10NOFPROPERTY�SNOWNBELOWORIITTACNFWRCOPIES� pROVISIONSOFL4'�NSANDORDINANCESGOVEqNINGTHISTYPE <br /> � OF WOHK WILL BE COMPLETED WITH WHETHERSPECIFIED HERE• <br /> wr_xoc�—oF I N OR NOT.THE GRANTI NCi OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OK <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> . OR TH O CE OF CONSTRUCTION. <br /> ' � ' �` � � � �N OF OR AUTHORIZED AGENT D�TE <br /> g•2$f <br /> ����yD APP CANTSCIttB INE LICENSENO. <br /> ' !�5/5 � �o k�� t�tN� ��tl�crs <br /> R,yM��� MECHANICIIL ' � �i�� � <br /> Np, T'PE OF FI%NRE FEE NO. TYPE OF EOUIPMENT FEE <br /> WATEH CL09ET TOILE AIR CONO.UNI75—H.P.EA ` <br /> �TM�B REFRIGERATION UNITS—M.P.EA <br /> - LAVATORV WA9H BASI BOILERS—H.P.EA � <br /> �pyyEp OAS FIflED AG UNITS—TONNAOE EA. ' <br /> KITCMENSINN8019P. FORCEDAIRSYSTEMS—B.T.U. Mt:A <br /> � DISIIWASXER WALL HEA7ERS—B.T.U. M <br /> � UUNGRVTMV UNI7HEATER3—B.7.U. M <br /> CIOTMEB W�MER EVAPOM7IVE COOLERS <br /> WATER NEATER CLOTMES ORVERS <br /> �q�� VENTILATION FAN <br /> DR�NKINO FOUNTAIN RANGE HOOD <br /> FLOOR ORIUN AIR HANOLING UNIT— C.F.M. <br /> VACUUM BREAKER9 - STOVE <br /> qOOF OMIN9—MINLEAUEN3 METAI.FIREPLACE 6 CHIMNEY <br /> BINN 8ERVICE—BA ETG 'NOODSTOVE/FIREPLACE INSER7 <br /> 8U!T0TI1L _ SUB TOTAL f <br /> PEIIMIT • PERMI7 t <br /> TOTALFEE i TOTALFEE f <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> iIIONT y[TyYCIf REAR K SIDE SET6ICK PLAN CHEGK MBEN/� MAN CHECN FEE <br /> V G �I� { DU FEEq2,� ss RECEIPTNO. 9Q�`( <br /> o T e�� <br /> UlE20ME LOTIIR V CANTSITE <br /> GI/ E9 ONO FF[! V111U�T10N FL[ <br /> TTKOFCd16T. OCCUPANCY AOUP NO.OFDWELLINOUNI73 <br /> 'Q N 8-2 H-4 -�- a���o�Na :525 �► <br /> NLlOI�l00 N[lOFB HIES M�KOGGp`qAU / <br /> ;;.-�� �0 � �i "4 T �` PWMBINO <br /> � MECHANICAL " <br /> PIRE PRINKLERS REOUIRED O YES NO <br /> O7HEfl <br /> � PENALTY <br /> M►LICATqNACC.BY PLANBCMaCNEDBY APP0.FORISSU�NGEBY . <br /> n- ' /f / � TOTAL <br /> �r� /��i V' <br /> �,p� r� Nl�t To � �87.8<� <br /> Gtivr.� �T� �"��� <br />