Laserfiche WebLink
� � � <br />Q�r�i <br />C N <br />9Hf/� <br />4 <br />o'i�(� <br />H �1 <br />� M � <br />UJ Hr <br />C+1 O � <br />H <br />��g <br />Q U �: <br />Cy� <br />HH <br />g �' <br />��y <br />HOW <br />� <br />1 �� <br />APPLICATItynl FUR CONSTRUC7.dPi IPERMIT `'"•"'" <br />TO BE COMPLETED IN INK—PLEASE PRINT � <br />mr e,.,.nm<-n <br />CITV OF <br />_____-- ____"--__ — ._ —__ <br />evere HEATING SYSTEA4: J GAS J ELECTRIC J_ � <br />BUILDING DEPAHTMENT �----�-- �—�- <br />259-8810 <br />DEMOLITION COMBINATION BUILUING MECHANICAL PLUMBING SIGN <br />o,vN�n um� n000vess — . oiv r�r, ��•.�r�� — jc�/ J— <br />r� � <br />L�1L5 '�'�� 11�' �%I�,l /i���%�i//���:' /:Cu�N.LL:-� `/JJ�:� i=3�— <br />1[NANT M411 ROOPE55 CIiV bP F E <br />O,RCNrtECiOROE514NER MAILADDRESS CITY IIP PMONE <br />�SIN[RALCOf1TRAGTOR A1R�LADORE55 LITV ZIP PHONE LICENSE• <br />!'i_CiIAN�C�ICONiRACTOR MA!LADDRE55 CIiY ZiP PHMIE i'CENSE• <br />Plo!ApINGLONIRAGIOR M�ILA0011E55 GILV ZIP �NONF UCENSE• <br />f l A'op Of WORN <br />NEW AODITION ALTERATION REPAIP DEMOUTION WOODSTOVEiFRPL INSERT BUILUING RELOCATION <br />corancr acasoe nmo m�oNe r�n <br />lOi <br />��. oF vro�vr <br />ANO SOU4RE F W iAGL INVJLVE C <br />>rauaoroc <br />ION OF PROCERtt ISHOWN 9EL01 <br />BLOCN OF <br />� -�'U C��- �Cr C � / C /- C- � �� <br />PLUMBING <br />NO. TYPE OF FI%TURE OR I <br />WATER CLOSEi1TO1LF.T� <br />SINK 8 <br />HER <br />'TRAV <br />�qAIN <br />FOR OFFICE USE ONLY: <br />raaa�seisnc� ncn�isetnncn <br />USfZONE LOiARCP <br />ivPF Oi CONIS I.IlOWABtE n'PF 04 CON51 ALiWt <br />SIZE Of BLDG. NO OF SIORIES <br />OCLUPANGYLO�� FINESPBYNL[RSRE <br />IN11.�.LIIV � PIAf1iAPPPUYCJOY <br />I HEREB� CERTIFV THAT I HAVE READ ANU E%AMINED TIiIS <br />APPLICATION AND KNOW THE SAME TG BE TRUE AND CORREC7. ALL <br />RiiALN�OURCOPIE51 PROVISIONS OF LAWS AND ORDINANC[S GOVERNING THIS TYPF OF <br />WORK WILI. BE COMPLETED WITH WHETHER SPECIFIED HEPEIN OR <br />NOT. THE GRANTING GF A PERMIT DOES NOT PFiESUME TO GIVE <br />AUTHORIiY TO VIOLAlE OFi CANCEL THE PROVISIONS OF ANV <br />OTHER STATE OR LOCAL LAW REGULATMG CONSTRUCTIJN OR THE <br />— PERFORMANCE OF CONSTRUCTION. THAT I A1d AUTHORIZED �V TNE <br />OWNER OP THIS PROPERTV 70 PERFORM THE N'ORK FOR WHIC <br />APPLICATION IS MADE AND 1 COMPLV WITH THE STA' <br />CONTRACTOFS LAW 1027 RGW AND 296.2001VAC <br />9GNRLUP[O�GOdiRAC10RORRUiHDRREDAGCNi CNF <br />X � <br />� �, <br />- — l� .�1'�y (j.c< Cc.Atf'leCf�-�—. ..—_.._— __ <br />/ . �� APPIICANi5GTv0U9 - � N'ENO AN06115ME55NAllC <br />FEE <br />r s <br />FEE 5 <br />MECHANICAL - <br />NO. TYPE Or EOUIPMENT <br />A C--A HNDLG UNITS—H.P. <br />FORCEC AIR SYS? EMS—B.TU. M <br />UNITHE4TERS-3.7.U. 1d _ <br />CLGTHESDRVEPS <br />V[NTILPTION FA�! <br />R�NGEhOOD <br />WATERHEA7ER _ <br />� \VOOD S70VE <br />METAL FIREPLACE i CHIMNEY <br />�IREPLACE INSER7 <br />HEAT FUMP <br />GAS P;PING <br />EXHAUSTFAN <br />—_ �-- <br />r•inr� i.��ecn r�uraoea <br />�UILDING <br />CCLVcIF'v NOINOAI_`.,. <br />cnoao� p�UId�ING <br />BASEMEHT h7EGHANICAL <br />HEIGNTUMrtRnON ADDITIONALPLANCHEGK <br />O7HCR <br />STAT[ CUILDING SURCHAIiGE <br />CITY OF [VEHETT runuc woans <br />LOCALSALES <br />TAX CODE IS 3105 TOTA� <br />u <br />PEiih11T <br />To�n � <br />VALUATION <br />FEE <br />