Laserfiche WebLink
/� A' C ;- <br />s-���L'C/"��101� rO�YYr rvcretl <br />�f iEvoeFgrean CONSTRUCTlaN O <br />;verett PERMIT <br />UILUING DEPARTMENT <br />Sg_g�qg TO BE COMPLETED IN INK- PLEASE PRIN'f <br />DEMOLITION d COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />,�'Eq� MAIL�D�PE55 Cltt Lln PIIONE <br />: �/�i � � . ��Inr;7lii�i;( �-?-�.� :! illi�_.(!"i �/�11i' '�f %.- !7.'„ <br />� �1:r. �'�' � <br />.tHIIECtORUE5IGNER MRILRODF�SS CIiY ZIP PMONE <br />�l . <br />. i �. "r� .�i�=..��li[;�:t /,r t�i� ���,% /c'� �l.l"(_.i,, /. t. ? . �. ; •�. <br />vERALGJNIOFCtOF MRIIP��R[5`> CIIY ' ZIP PIIONE UCENSE• <br />f.11ANIGAL CONIliRCiOR IAFIL FODRE% CIiY ZIP PHONE LICENSE � <br />UM0IN,CONTPALtOR 'AniLn�DRE55 Clrv LIP PIIONE LiCE�lSE• <br />n55 Of WORK <br />� NEW ❑ ADOITION O AITERA710N ❑ REPAIR ❑ DEMOLI710�! ❑ WOnDSiOVE/FfiPL.INSERT ❑ BUILDING RELOGA710N <br />W NLION OF WOFN i�OST OF MATERIALS PlUS �FBORI <br />�%'. . / ( �� <br />'�( .7: <br />cn� oesceiv <br />r_eu <br />%�lil i i�i'� . <br />fIi <br />��I C� ��l" i' C': n�;� i ��.'� � l6', <br />ONT <br />E ZONE <br />G-� <br />fE OF CON51 <br />� � <br />ZL OF OLOG <br />. ��Crl�i�f��n.!'ir4.'��',7:Jr,�i;'�ia4 I(sn[il;,�i�li<'�"-J.,J /bf.i'�f.� .n:i i7Gf. <br />1 HEREBY CERTIFY TFIAT I HAVE FEAD AND EXA�IINED THIS AP- <br />PLICATION AND KNOW THE SAMETO BE Tf7UE AND CORRECT. At.L <br />fOURGOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHiSTYPE <br />OF WONK WiLL 6E COMPLETED WiTH WHETHER SPtCIFIED HERE- <br />— IN OR NOT. THE GRANTING OF A PEHMITDOE.�'i NOT PRESUME TO <br />GIVE AUTIiORITY TO VIOLATE OR CANCEL THE PROVISIONS O� <br />ANl' OTfiER STATF OR LOCAL LAW REGULATING CONST. RUCTION <br />OR THE PERFORMANCE OF CONSTRUC1�17N. <br />SIGNATURE OF CONTRACTOfi OR AUiNORIZED AGf :T DATE <br />X!� ���I--c.�r. V :l�:c'CtU� '��41V�,`/C ���0��. <br />nPPLICANTS Clrv 9JSINE55 L�LENSE NO. <br />, r. ..�.-:, ,.,a � � �' S � — <br />NO. TYPE OF EOUIPMENT — FEE <br />AIP COND. UNITS-.'7.P. EF. <br />r�, t l i 4 0 'L W -�-� nui�tNn-n.r. cn. <br />GAS FIflED AC. UNITS-TO� <br />- FORCED AIR S�SiEMS-6.T <br />DTJ WALLHEATERS-B.T.U. � <br />UNIT HEATERS-B.T.U. M <br />EVAPOPATIVE COOLERS <br />_ CI.CITHES DRYERS <br />v <br />� <br />rr:nMir s <br />v <br />renrnir . .. _ . 5 � .. -- -.. <br />THIS P�RTION TG� BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />RERRSE(BACK SIOESETUACH fLRNGHEGKNUMBER pPZLAUCMECKFEE <br />— � , h ' fEE (J_/ �ECEIPi f10. �`� � <br />� �6 I - <br />LOI \FE,A1 yqCNtii SRE FEES VAW�TION F--EE ----� <br />�V.A. ❑VES �O _ '— <br />OCCUPAJCYGIIOUP NO.OFDWELLINGl1NII5 -} <br />f�-2 � evaou+c 52 �`l`'A � � �lo I `Tj <br />IF[�Z ]] <br />�RE SPFINMLERS REOUIRED YES <br />1Y <br />M.� I ��.� <br />MR%.00C LOnO A <br />�0 PWh18��.G LF' (J� <br />MECHnNICAL l� u� <br />OTHER _ <br />PENAITY <br />F00.155UaHGE OV 1 ,.,1� �.-�l <br />TOTAL � (j U <br />G .c . — <br />n,� Wo� �,r�� ����� <br />Pc,�cr �' ►'`��-�'-. 'E�-^'i.-cs r-•=�Y <br />� �' � . <br />z <br />O <br />-i <br />c") <br />m <br />.. �+ <br />--I '� <br />.-� -1 <br />tn x <br />m <br />ci <br />c c <br />�-� o <br />� <br />O 3 <br />m <br />S �--1 <br />m <br />.. <br />a z <br />C <br />a --i <br />rx <br />-i in <br />-c <br />c� � <br />T 3 <br />—i m <br />x <br />m� <br />N <br />o r <br />c� m <br />C V1 <br />3 N <br />Z C'� <br />.� m <br />D <br />A <br />�--I <br />S <br />a <br />z <br />-1 <br />x <br />� <br />z <br />0 <br />-� <br />� <br />m <br />