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+ � ��PPLICATION f0�,� <br /> : a`�'"" �CONSTRUCTION ��e <br /> ; �Ve1'ett PERMIT <br /> BUILDING DFPARTM�NT <br /> 259•8745 Tn BE COMPIETED IN INK- PLEASE PRINT <br /> �1�CC�- <br /> ❑ DEMOLITION ❑ COMBINATION �el BUILDING ❑ MECHANICAL O PLUMBING ❑SI(iN <br /> pWMER M�R�D�RE58 CItY LP PNONE` !� <br /> ��� �, ��,� �;� �.:� �����n %x� �►��� �ve C�IEc���, �l -,�o� ��4 <br /> MCMITECIOAOESiONER MMLSDDRE55 Cltt � ZP PIONE <br /> Cf <br /> i r � r <br /> OENEMLCONiMGTOR lULL�[�O�ESS Cltv PP VNONE LICENSE• <br /> (� �� �� � <br /> MCCH�NIULCONIR�GTOH MUL��OP[SS CIfV tIP PIIONE LIGENSE• <br /> PLVMliN�CONTR�CTOR M�IL�DDAESS GITY ZiP VIIONE LICENSE• <br /> C111 WORK,�y�^c-! I <br /> I NEW K.� ^DD� ❑ ALTER�TION ❑ f1EPA1R ❑ DEMOLITION ❑ WOODSTOVE/FRPLINSERT ❑ BUILDINO RELOCATION I <br /> �.LYATIONOfWOPflICO510FM�1ENI�L5�lU5L�BCR1 C .p .� , 1( ll � I <br /> t�A-�c��.� C—._x c�r���_ = �� ° � , j <br /> � DElCR� E WORR <br /> � � L I�CJ l T U — �C=�C �� <br /> � w[or ew�o�wo � \ I HEREBY CERTIFY THAT I HAVE READ AND EICAMINED THIS AP- <br /> '1 �_–_ C� t� PLICATIONANDKNOWTHESAMETOBETRUEANOCORRECT.ALL <br /> � LE0�ILDElC11DT10MO�PROVERTV��MOWHlEIOWON�TT�CNiOURCOPIE51 pAOVISWNSOFLAWSANDORDINANCESdOVERNINOTHISTYPE <br /> OF WORK WILL BE COMPLETED WITl1 NMETHER SPECIFIED HERE- <br /> i io _ INnRNOT.THEGRANTIN60FAPERMITDOESNOTPRESUMETO <br /> � � �Er �� 1 l^ GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVI910N5 O� <br /> � � G �F, , Ofi T�T PE FORMA C OF CO STRUCTION. 6CONSTRUCTIO,N <br /> 81ON TURE FCONfR�CTORORAUtMOR12E0 NT DATE <br /> ' I- / ��� �0 <br /> .� <br /> � <br /> � T C�l ' � ��r 1VPLIC�NT9 Ii� SINF39LiCEN4E NO ,, <br /> l� � <br /> 7� � �� U <br /> i MECMANIC�C <br /> � �LYM�INO __ FEE NO. 1NPE Of EOUI�MENT �E� <br /> �p. TY/[OF FIKTUII[ <br /> WI1iFR CL09ET�7011EP AIR CON�.UNITS–N.P.E11. <br /> 9ARITUB REFRIOEPATION UNIT9–H.P.EA <br /> ' LAVnTORV WASH BA91N� BOILERS–M.P.EA. <br /> f SHOWFR 6�S FIRED AC.UNITS–TONN�OE EA � <br /> � 1(ITCHEN$INKl019P. FOHCEO Alp SYSTEMS–B.T.U. M E�. <br /> 1 <br /> � DISMWASMER WALLNE�TERS–B.i.U. M <br /> �1 LAUNDRYTqAY UNITMEATEFS–B.T.U. M � <br /> ? CLOTHES WA9HER _ EV�POMTIVE COOLERS <br /> WATEN HEATER CLOTHE9 URVEPS <br /> �� UPINAL VENTILATION FAN <br /> ; ORINKINO FQUNTAIN RANOE HOOD <br /> FL001i�RAIN AIR HANDLINO 11N1T– <br /> s V�CUU"rABPEAKE 9TOVE — <br /> pppF DMINB– MNLEADERS METAL FIREPLA 6 CMIMNEY <br /> BINI( SERVIC –B11R ETC. WOODSTOVE/ REPL�CE INSERT , <br /> i <br /> � — <br /> i — <br /> _ _I _ _ <br /> /U�TOTAL 6UB TOTAL � <br /> OEIIMIT { PERMIT � <br /> TOTALFEE t TOTALFEE � <br /> { THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> j iRONTBETB�CR RF.APSEfBACR ' SIOE9ETMCK ' PL�NCMECKNOMBER <br /> PL�N GNECK iEE <br /> � I f yy , ` pEE `O PEGEIPTNO. <br /> 1V I <br /> + UDE20N: p LOf7�RE� WC��iE I[[t V�LUIITION F![ <br /> � /1 '.f �'•�73 00 ? ores o j <br /> � TTPEOFCONlT. OCCUV�N'CAYGROUP NO.OFOWELUNOUNIT9 /y/j�J'') 7� <br /> . �✓/� I �' BUILDIND f �.�(/v6�� ✓ <br /> 1 <br /> � �ILE OF BLDO NO OF S�IE9 M�K.00G.LO�D <br /> � '/ � PLUMBINO <br /> � ir <br /> j MECNRNICRL <br /> � FI E PRINKLER3 REOUIRED ❑YES G O1NER <br /> � PEN�LTY <br /> � <br /> t �PFUGITION�CC.B� �L�NSGNECKEDBY APFNfORI55U�NCEBV � <br /> TOTAL <br /> L -c. <br /> � � �.�4 <br /> � �� ` <br /> a <br /> .��* <br /> - -�: -i � . t`:' .J�'�. y. - — �.�, � ,ir'i` i. <br />