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APPLICATION FOR CONSTR�JCTION PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: ❑ GAS ❑ ELEC7RIC ❑ � <br />259-8810 <br />'. i DEMOLITION � COMBINATION i; BUILDING '� ! MECHANICAL '�� PLUMBING ��, � SIGN <br />OWNEN MML�OJRE55 ��}Y IIP PIq:4 <br />R�cuuan c�g�� �P'� 'Pr,x 2215 EVE'RE_TT 9€�2c�1 <br />1EN�IR PAhADJfl[55 LIiY bP PIKKIE <br />ARCNIIELiOR0E5iGNER M.11L <br />GENEIIALGCNIRAC�'P NMIAD�PE55 � CIiV ZiP PIWNE S1AlELICEN$E� <br />M�6Ri� coN� 224- ti��GCesotil .So-=A i��� 2-R'j�71zi McFSR�'�o���� <br />MECN�NqA.CON1flµ;i0P YAI.ADOPE59 CIiY IiP VNONE Si�i[LICENSE• <br />PWIABiNGCp111UCi0R MAll.00flF55 �IiV IiP FIION[ SiAiELILENS[� <br />cussorwonK <br />. NEW � ADDITION <br />CONIPACt PPiL6 OF WOPN <br />DESLP�BE W011M AND $OOAPE R <br />FiA.rL 2�lMtR � <br />rnoroseo use a owm�n+c <br />CKISTI Sx_ <br />IEWI �E:CP °i pl OF P W JCfl <br />ior e�nR <br />rnwr.ct �ow�Ess <br />FOR OFFICE USE ONLY: <br />PFASOu fOF S�qi4REP5 <br />ALTERATION XpEPAIR '. ��� DEMOUTION . WOODSTOV6FRPlINSEPT � BUILOINGRELOCATION <br />I HEREBV CERTIFY THAT I HAVE REND AND EXAMINED THIS <br />hPPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />�owon e**e<n couaeories� PROVISIONS OF LPNS AND OHDINANCES GOVERNING TMIS TVPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />o� NOT. THE GRANTING OF A PERAIIT DOES NOT PRESIIME TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHEF STATE OR LOCHL LAW REGULATING CONSTRUCTION OF THE <br />PERFORMANCE OF CONSTRUCTION. 1 HAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PFOPERTV TO PEPFORM THE N'ORK FOR WHICH <br />APPLICATION IS MAOE AND I COIdPLV WITH THE STATE <br />CONTRACTORS LAW 1B27 RC W AND 29G200 \YAC. <br />n <br />� <br />i������ ./L � 8'�Z _ <br />�....��m� w�� <br />ar I MxsnvPaJeEoav <br />5 <br />om,ruc. I w <br />caar <br />CIN OF EVEHEfT <br />LOCRLSALES <br />TAX CODE IS 3105 <br />nmi.o��ru� <br />PWMBING <br />MECIIANIGAL <br />A��It10NPL PIAN CHECK <br />SPFINNI[R <br />STATE BUR�ING 3URCHARGE <br />PUBLIC WOFKS <br />TOTAL <br />iEE <br />