Laserfiche WebLink
APPLICATI� FOR COPISTRIUC'1�N PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PR'NT �- <br /> HEATING SYSTEM: U GAS U ELECTRIC U � <br /> BUILDING DtPARTMENT <br /> 259�8810 <br /> i i DEMOLITION I I COMBINATION �!BUILDING I I MECHANICAL I i PLUMBING I I SIGN <br /> ovm[n Mea/.00n[ss G'r iiv ivqME <br /> /,v7'�ACa�P �sos sE�No ,4uE �`� �en�� G�i+ (035-91Ni <br /> .OPlli M�ILnOqIE55 GIIV ZIP PIqNf <br /> Lse C�exExY <br /> ennmcctono[smnen raeRnamcss an zir viarvc <br /> IHN�E ,GIUE'[LE� �go <nrFs.oc �2so �irrTlE w�. 96�aa 3aS-�SS3 <br /> ccucneica+meciou �.�nnnonms: cm nr rvaHe suntcer+se. <br /> /N%�'RPGRP .a5a5 .5c'LONO /}uE. ��o �r77ZE�� /a �S- 9a3G <br /> McuwicKcornnecx.i �urt�oonc,s cirv nr Aarve SUtEICENSE� <br /> Jn ,BE Le�Tta,ui,vr_-D <br /> PW40WGCONI^\CIOP MLKI.ObBE55 LIiY ZIP %p11E SG'EIILEN$E• <br /> To .?�c' �c�e.ea.ut-� <br /> C1�55Cf WOIIN <br /> I I NEW I I ADDITION � I ALTERATION I I REPAIR I I DEMO�ITION I 1 WOODSTOVFJFRPLINSERT I I BUIl01NGRELOCATION <br /> � c9ti7�ct r[nsa+u�o w�w+e no <br /> CpiiqALl PPIL[OF WOfIN �a 7s'�a-p p °= ✓���,�,� �/e,p,p. - G,�.v� �t?veude f`,�Issa. <br /> ocscnmf vronK,wo sd��n[�oot�c.r mvavrn <br /> 7'z'_��- v ia4-J 90o S.F. ��s• ass3 <br /> rnansmus�wuuenJ a I IIEREDY CERTIFY TIIAT I HAVE HEAD AND E%AMINED TIIIS <br /> G7�/`���_�Q �jDQ• (U2�S . APPLICATION AHD NNOW THE SAME 70 BE TRUE AND CORRECT ALL <br /> i[cuor.crtrurnorrnormrviv�ovmouownnqucu:wncuwcs� PROVISIONSOFLAWSANOORDINANCESGOVERNINGTl11STYPEOF <br /> WORK WII L OE COMPLETED WITH WHETIIER SPEGFIED HEREIN OH <br /> ior� oimK � bV�/.✓._.�1L�' NOT. THE GRANTING OF A PEPMIT DOES NOT PRESUAtE TO GrvE <br /> AUTIiOHITY TO VIOLATE OR CANCEL TMC- PROVISIO�lS OF ANV <br /> �AN_�F�,(/�x.rpoFiO •�EJhUA - �OTIIER STATE OR LOCAL LAYI REGULATING CONSTRUCTION Ofl THE <br /> PEISFUR^AANCE OF CONSTRUC110N.TIIAT I AM AUTMOFIZED BY TNE <br /> �CDA-'�t�7 C A�PPLICOOTNISS�OADETANDPECOMYLV WIT�NKT ERSTATE <br /> CONTRACTOR 1827 CW D296200WAC. <br /> �- � - --��( ��. 3/• 9� <br /> r�er,t noness pf1•"^` o•" <br /> q�o �r,rica � �,,.w,5m,s=,��,.,M, <br /> PLUMBINO MECHANICPL <br /> NO. TYPE OF FI%TUNE Ofl ITEM FEE NO. TVPE OF EQUIPMEIIT FEE� <br /> WATER CLOSET(TOILET� A'C--AINNDLG UNRS—HP <br /> _ BATHTUO i _ FORCED Alfl SYSTEMS—U.TLL M E.A. _ <br /> LAVATORV�WASH�ASIN) UNITHEATERS—BT.U. M <br /> SHOWER CIOTHESORYEflS <br /> NITCH[N SINK 8 DISP V[NTII ATION FAN ' <br /> OISIIIVASIIER flANGE IIOOD _ —�— <br /> LAl1NDRY TRAV WATER H[ATER _�_ <br /> ClOT11ES WASHER WOOD STOVE <br /> URINAL MEiA�FIREPLAC[8 CIIIMNEV <br /> ORINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOP DRAIN HEAT PUMP <br /> OACKFLOW PR[VENTER$ GAS PIPWG <br /> ROOf-ORAINS—RAINLEADERS [%IiAUST FAN <br /> SINK(SERVICE—DAR,ETC.) ' <br /> —i—— <br /> _ _ _ �_ <br /> SUD TOTAL E SUO TOTAL E <br /> PEfiMIT f —� PERMIT f <br /> iOTALFEE S TOTALFEE f —�—_ <br /> FOR OFFICE USE ONLY: 0 i�/-� � <br /> nrorrtscteecx neensciwcn swescrnncn riuwe¢�H�� m v ncccirrxo <br /> ,S �Id3•�3 <br /> uscm�e �orenu vncurtsne FEES VRLUATION FEE <br /> OWl01NG . ��S o�� /rl�r-1 ! .�[� <br /> irr[ortoxrsuiorruic rncaca1si�auu �����M� wao».uwcv.n 1 <br /> V ' �J ✓ .. �J �4P°� Pll�M01NG <br /> 5¢EOCOIDG NO CPSIWI:[5 0 �u[Nf MEGIIANICAL <br /> � � o0 2 N� - <br /> ix.cure'¢riam Rucsrnrvp[nsm:uo nEiG�rtlwn��p� /�OIIIONRIPUNCMECN ��� � 7i7 <br /> 3`� 3 ��'S _ si�niNK�cn � <br /> nusorrtonsn�w�}ms — <br /> _l�( C ICO. _ 9f% `�/A�� r = suiinunon+csur+c��ance �'�J <br /> munurc rYerrs •ry{pvenor CITYOFE flETT pwuc�vones <br /> <<� LOCRLSALES <br /> 7 �� TRX COOE IS 3105 TOTa� <br /> I ^2-'� i <br />