Laserfiche WebLink
`�'`'' PPLICATION FO�+' ��«<� <br /> �:... <br /> f��Er�rprNn CO N ST R U CT I O N e <br /> Cltt OF <br /> e�,�erett PERMIT <br /> BUILDING DEPAR7MENT TO BE COMPLETED IN INK• PLEASE PRINT <br /> 259•8745 <br /> ❑ DEMOIITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> M�I�l�ODPE55 GIfY Z�P PNONE wl� ���� <br /> O1W��ER /I� ^� 3'.Ff-3 50 3�f$-4111 <br /> ` �{� \ 51 `v ZIP PNONE <br /> �RCMi CT OR OESIONER <br /> MML AODRE59 ��ry <br /> GENE R�I.COHiR�CIOA <br /> M�II�DDRE99 Cltt ZIP PNONE LICENSE• <br /> MEGN�NIC�L CONiR�CIOq <br /> M��LA�ORE55 Cltt ZIP PHONE LICENSE• <br /> iLVMBINO CONTPACIOR <br /> M�IL�OONE55 ��n' ziP P��ONE LICENSE• <br /> CUSSOF WOPN <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION �'�'OODSTOVE/FAPL.INSERT BUILOING RELOCATION <br /> VALWTION OF WOPM�LOST OF M�IEHIRLS PWS LAB0111 <br /> 0�9E WOpN � � <br /> useoreuaoi�c _� I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> �; � � PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.AIL <br /> .L � <br /> �ca��oesc P110NOFPROPERfY15N0 NBELOWOR�iT�CNFOUPCOPIE91 pROVIS10N50FlAWSAN00RDINANCESGOVERNINGTHISTYPE <br /> p•,,;�,o„ �opl4-t� o� ,' � OFWORKWILLBECONIPLETEDWITHWHETHERSPECIFIEDHERF• <br /> LOi_�BIOC�—or IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> �^ 1 GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> �. ��a, 0,1_ 1b-F � VC>�4.fi�n �O ��3 � � pRTHEHP RFORMA�NCE�OFCONSTRUCTION. GCONSTRUCTiON <br /> SIGNATURE OF CONiRRCTOR OR AUTHORIZEO ACENT D/TE <br /> X <br /> APPLICAN i'S CITY BUSINESS IIGENSE NO. <br /> PPOJEGT�DORE55 � � <br /> 51a ��.(,1�o�1t e� -t <br /> MECHANICAI - <br /> PLUMBIN6 ____-- TYPEOFEOUIPMENT FEE <br /> NO. TYVEOFFIX�URE FEE NO. <br /> _ AIR COND.UNITS-H.P.FA <br /> WA7ER CLOSET(TOILEi) _ <br /> REFFIGERATION UNITS-H.P.EA. <br /> BATHTUB <br /> BOILERS-H.P.EA. <br /> LAVATORY�WASH BASIN� <br /> GAS FIRED AC.UNITS-TONNAGE EA <br /> SHOWER <br /> FORCED AIP SYSTEMS-B.i.U. M EA. <br /> KITCHEN SINK 8 DISP. <br /> WALL HEA7ERS-B.T.U. M <br /> DISHWASHER <br /> UNIT HEATERS-B.T.U. M <br /> i LAUN�RYTRAY EVAPORATIVE COOLERS <br /> CLOTHES WASHER CLOTHES�RYEPS - <br /> WATER HEA7ER <br /> VENTILATION FAN <br /> UHINAL <br /> RANGEHOOD <br /> DRINKING FOUNTAIN <br /> qIR HANDLING UNIT- GF.M. — - <br /> FLOOR ORAIN SiOVE <br /> VACUUM BfiEAKERS . <br /> flOOF ORAINS-RAINLEADERS METAI FIREPLACE d CHIMNEV <br /> WOODSTO�FJFIREPLACE�NSERT <br /> SINK ISERVICE-UAH.ETC. <br />� SUBTOTAL SUBTO7AL s <br /> f PENMIT s <br /> � PERMIT T0T11L FEE 3 <br /> TOTALFEE 3 <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> PUN CHECN NUMBER P��N CIIEGK FEE <br /> fFONt SEIB�CK RE�R SELB�CN SIOE SE7B�CK fEE REGEIPT NO <br /> USEZONE LOT�REA y�C�NTSITE FEES V�LU�TION FFE <br /> OYES ONO <br /> TYPEOFGONST. OCCUPRNLYGBOUP NO.OFDWEIIINdUN1T5 <br /> BUILOINO s <br /> SRE Of BLDG. NO OF SiONIES M�K OC4 LO�O <br /> PLUAIBING <br /> MECHANICAL <br /> . FIRE SPPINKLERS REOUIRED ❑ �ES O NO OTHER <br /> PENALiY <br /> APPIICAiIONACG OY �UNSCHECNEDBY APPRFOBISSIIANGEBY <br /> TOT�L <br />