Laserfiche WebLink
. �i <br /> s. <br /> � ��LICATI�JN F(�R`� � <br /> �_ �everetl <br /> � f!I�Ev110lNR C O�P E�A�t�TT!O N � 1� ' ,� <br /> GItt OF 1 <br /> evF�r�'�t ' <br /> � BUILDINGDEPARTMENT ;F�f� <br /> '� 259-8810 TO BE CUMPLETED IN INK- PLEASE PRINT � � //_ ,�`� <br /> � ❑ UEMOLITION O COMBINATION ❑ BUILDING ❑ M'eCHANICAL ❑PLlJ1VfHiIV `/��!_SIGN <br /> � MAILADORE55 GITV 21P P ' NE ' <br /> �,} ONNER p � �Q� �r yo6 � <br /> :� rn�k�l�oS��ioo ��st'�� 9No�Shara�; �e �UPre1� W y8ao � <br /> �RGMITECfOF ESIGNER MM�VDDPESS CiTY 2�P PnONL <br /> � ('jross�T�ivrmah � DP/11ei5 / I✓SfWPs�Bv',l�ina �ov seatl'�E W�i 9�/l9 28/' 8790 <br /> '' GENERALCUNiN�C10R MAILA�ORES$ Cirv IIP P��ONE LICENSE• <br /> � SGm �. �,_.tT ow.�c/ <br /> � IAFGNANIC4l_COj1TNAGTQN MAIL�OONF55 CIiT ZIP �'1101JE LIGENSE• <br /> + /_ /� MPIIADORE55 CITY ZiV PIIONE LICENSE• <br /> .I PLUMBINGCO�/iRPGiO� <br /> 1 N//`� <br /> C1�55Oi WOAM <br /> ;j ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ OEMOUTION ❑ WOODSTOVEJFRPL.INSERT .� 6UILDING RELOCATION <br /> .�J V�LUA NOFWOaN�CO510FMAtERIAL5PW5UBOR1 <br /> q ���� '�7U — — <br /> `J OE NIBE WORN / � <br /> �a�E Nx�s r� n+ E c 3 �ovm N 7�� �Gr'4 ��i�'�7 ti'�� <br /> � USEOFOUILDiNG I HEREBY CERTIFY THAT I HAVE READ AND EXHi.!�NED 7!;iS AP� <br /> � C/G�SrUOM PLICATIONANDKNOWTHESAMETOBETRUEANOC�'"iHECT.AII <br /> LEO�LDESLRIPiIONOFPROPENiVISMOWNBELCWOAA�T�CHFOURCOFIE51 PROVISIONSOFLAWSANDORDINAVCESGOVFRI:!YGTHISTYPE <br /> � OF WORK4'�ILL BE COMPLETED WITH WHETNER SPCCIFIE.'"i nERF� <br /> � �or—e�oc�c._—oF INORNOT.THEGRANTINGOFAPERMITDOESNOT?RESUMETO <br /> GIVE AUTNORITY TO VIOLATE OA CANCEL THE PROVISIONS OF <br /> '' ANY OTHER ST�TE OR LOCAL LAW REGULATING CONST^VCTION <br /> i� OR THE PERFORMANCE OF CONSTRUCTION. <br /> � 9iGNATUR�OFC IRAQGRORAUTNORIZEONGEM pAiE <br /> � �c�Yr�'AJ �t-4C7J x � ����. �—a�-8i'r <br /> �) PBOJECiA�DRESS � / ��, n0 LICP �SLIPIOIISINF.SSLILErv5EN0 <br /> � 9(a�D r7°�� <br /> �� PWMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> :I WA RCLOSET�TOILET) A/C—A/HNOLGJNIIS—HP. <br /> i BATH B REFRIGERATIONUNITS—HP.EA. _ <br /> '� �VATO (YlASH BASIN� �OILEaS—A T U/H P. ' _ <br /> '�+ SHOWER GASFIREDAD.UNITS-9.T.U. <br /> ,J KITCHENSINK DISP. FOFCEOAIRSYSTEMS—B.T.LL MEA. <br /> �i DISHWASNER WAILHEATERS—B.T.U. M <br /> j LAUND7YTPAY UNITMEATERS--B.T.LL M <br /> � CLOTHESWASHER EV/.PORATIVECOOlEFS <br /> � <br /> '� URINAL � CLOTHESORYERS <br /> OF�NKING FOUNTAIN VENTILATION FAN <br /> : RANGEHOO� <br /> FLOORORMN <'� <br /> -,{ BACKFLOW PREVENTER WATER IIEATER ��� <br /> ,! WOODS�OVE <br /> � ROOFDRAINS—RAIN OER$ �_ � <br /> SINK�SERVICE—BA .ETC.) METALfIREPLACEBCHIMNEV <br /> rl FIREPLACEINSEFT � <br /> ' I ,� <br /> HEAT PUMP � /f� <br /> .y -- GASPIPING l..,.� <br /> 1I+ E%HAUSTFAN (g. <br /> ll (i� <br /> � SUB TOTAL S SUB TL`TAL �..� <br /> 1 <br /> PERMIT f PEflMIT <br /> TOTALFEE S TOTALFEE ���� <br /> PLAN CH CK NUMBER FEE REC �PT NO.� <br /> iRONTS[T9�CK AERR 58iBA�K Si�ESETB�CN y � 5 <br /> 3; ' � ' 3 i ' zo' C ' 38/�� �L�� -�� �_ � <br /> �'� USE20NE.•J LOiAPE� vncu,�,sr� FEES VALUATION FEE �, � <br /> ( �) fI,YES ONO { <br />�+ �� BUILDING SL 1 ,i <br /> TYPEOFCONST OCCUPANGYGROUP NOAFDWELLING�NIiS '�j�+� <br /> � fn/Ou/� � �ni�S yC/4SS��M PLUMBING � <br /> SiZEOfBIOQ (�y NOAFSTORIES MAXOCGLOAO : ��H <br /> � I GC I 7 vnl�"' MECHANICAL / �— "; <br /> t , <br /> j � OTHER � -- i . <br /> i <br /> 7 FIi1'_SPRINKLERS HEDUIRED ❑ VES NO STATE B ILDING SUF7CHAPGE � � <br /> Y - <br /> .li STATEENERGYSURCHARGE � � <br /> + 1VPlILAf10NACC flY PLANSCMECNCDOY �PPR.fOB155UANCE6Y � �� <br /> PUBLIC WORKS _ I�� .. � <br /> � � �� <br /> rl � �. A ���� TOTAI � <br /> �� �V v .v C�J c,lJ <br /> � ' PROPERTYOWNERSARERESPONSIBLEFORDETERMININGAL: <br /> PROPERTY LINE LOCATIONS AND RELATED EASEMENTS. <br /> ! <br /> ( d�.... n� _,.. . . �.. .� .. ... .. . ..�; ' . ..,. .� ,� .. . � . . .. . .,, . . ... . . , _.: .. . ..�� ,._ . <br />