Laserfiche WebLink
� <br />`�r►�'PL�CATIOf� FOrc <br />Ine Everpreen C O N S�' [�. U CT I O N <br />CITY OF <br />eyprett PE RM IT <br />TO BE COMPLE'(L^ IN BLACK INK— PLEASE PRINT <br />BUILDING DEPT. <br />259-8745 ❑ COMBINATION ❑ PUILDING ❑ MECHANICAL <br />everrtt <br />� <br />❑ PLUMBING ❑ SIGN <br />MRILR��OE55 CILY ZiP PMONE LICENSE• <br />GENERALCONTHFCTOR (��pZ 99M Q���/.E. � <br />i�,in..���,icP i���c.T2�ir-nn..1 �"SV/cc.E 1�L)O �i'2��7`/ C1iQl.�l� 19007 <br />MAII RODRE55 <br />zir <br />PlUM01NGCOHI(VnCTOR MRILRD�NE55 CILY ZI� PMONE IICENSE� <br />CLFSS OF WONN <br />❑ NEW ❑ ADDITION � AL7ERATION ❑ AEPA�R � GEMOLITION ❑ Wnn�STOVE/FFPI..INSERT ❑ BWLOING RElOCA710N <br />VAWRTION OF WORK �COST OF M�IERIALS PWS LABORI <br />�Q� • r — <br />�ESCHIBE flK <br />TF_niANr �mPeovFMErJt . — <br />FpON� <br />oF <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAI�AINED THIS AP- <br />�oJ9f PL�CATION AND KNOW THE SAME TO BETRUEANDCORRECT. ALL <br />UELOWORRRAGMFOUPLOPIES� pROVISIONSOFLAWuANDORDINANCESGOVERNINGTHISTYPE <br />OF WORK WILL BE C(?MPLETED WITH W'iETHER SPECIFIED HERE- <br />IN OR NOT. THE GRANTING OFA PER!.11T DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRGVISIONS OK <br />ANY OirfER STNTE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFOFIAANCE OF CONSTRUCTION. <br />SIGNAT��C�j..�A j�U�� RIZEDAGENT ��'�� <br />i <br />X � �� <br />v: <br />.r aooness p, q��,�n� <br />�O�j �L'v£2£T rnAtL wR; f3u5�,vFsS <br />USE ZONE / <br />c.- <br />ttPE OF CGNST. <br />N. �• <br />512E OF �LOG. <br />N.A. <br />hC <br />s <br />M <br />THIS PGRTION TO BF COMPLETED BY BUILDING DEPT. PERSONNFL <br />PPPUCR110N FCC. BY <br />�� � <br />P[M SEI�ACH <br />- N A• <br />ioinnen <br />N. A• <br />OCCUPnt�CY GRi <br />�S- 2 <br />NO.OF StOP1E5 <br />✓�,� <br />SIOE SEiBACH <br />VAGANi SITE <br />uves xruo <br />NO.OF OV�{t <br />FOR ISSI/AN <br />�-C <br />FiPN <br />BUILOING <br />PLUh1BING <br />MECHAhICAL <br />OTHEF <br />PENALTY <br />TOTAL <br />FEE.^v <br />FEE <br />�EE � � REClIPTNO <br />— Q� 36/ <br />VALUATION FEE <br />Z <br />O <br />� <br />n <br />m <br />—�i �l <br />�. -i <br />l/l S_ <br />m <br />co <br />mo <br />-i c <br />om <br />_ -�i <br />m <br />p Z <br />C <br />a -� <br />�_ <br />� N <br />< <br />'T1 <br />O A <br />-� a <br />3 <br />--i m <br />x <br />m� <br />� <br />O <br />or <br />�m <br />C VI <br />3 � <br />m <br />zn <br />-� r <br />• m <br />a <br />z <br />� <br />x <br />a <br />z <br />� <br />x <br />N <br />Z <br />O <br />�--I <br />.-� <br />C� <br />m <br />