Laserfiche WebLink
: , , . _.... . ..::...... <br /> i <br />' ,�PPLICAYION FO�. ���;�„ <br />� '°'E""""° CONSTI�UCTION � <br /> cm ev <br /> everet�t PERtiiIT e <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPL'�TED IN INK - PLEASE PRINT <br /> ❑ OEMOLITION ❑ CO�d81NATION ❑ 3UILDING ��NECHANICAL ❑ PLUMBING ❑ SIGN <br /> O"WtH n�� ��>�I ADORf55 Cli ZIP PIIDNL � <br /> `�QXYpS I-1fY11�rll�n� I bI�D 1�^ifYP t �i L 1� �-�L�VYL�' G��U� ��J'l-��CO(2— <br /> r,naur[c�onutsm��en nunnnoe[ss an riv r,�or�� <br /> GlNER�L CJNi�VApOR b1aR app11l5ti (:i�r Li� vuON[ i iCENSE• ��. <br /> \('H�CONIlInCTOq�� � M1�ap.a��55 f,lrv �� 2iPI PI�ON[ IiCENSE• �� <br /> � �1c� - � u��r�� t�.��� ,-��1-Su�la vr�-� �� �,- ; <br /> PLUM�INGCOILIN CfOR AIAII.PDO��[55 (:IiY IIV PPONE IICE�E • I <br /> CLPSSOG WOON <br /> . ❑ NEW ❑ ADDI710N ALTERAI'ION ❑ REPAIR ❑ DEMOLI710N ❑ WOODSTOVS/FRPLINSERT ❑ BUILD�Nu RELCCA710N <br /> VFIUAiION Of WORn�COST Of IAAIEf1.I.S PLIIS I.PBOB� <br /> OESCRiOE WJRK . <br /> ZV4_�-fl D Q�.�1LC;. �'1 4(-_' �-9Jl , �• . - �tiQ - , <br /> use o ouaorl�; I HER[BY CERTIFY THAT I NAVE READ AND EXAMINED THIS AP� <br /> 1� PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> lCGnlDESCRiPi�OHO�PROP[RiYISNOWNOELOWO�iAiTAC��fOtiRCOPiES PROVISIONSOFLAI^!SANDORDINANCESGOVERNINGTHISTYPE <br /> OF WORK WILL BE COMPLE7�ED WITH WHETNER SPECIFIED HERE• <br /> ioi_aiocK—_ov IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOI 4TE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STAI'E OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. , <br /> SIGNAIUFEOFGONiRq�TGPORFUTHOR4E0AGENi pAiE <br /> X <br /> PFOJEf,f ADORhSS aPVLif.n�+iti f.IIV Biiti���FSti 1 if,Lt�SI��O <br /> �,I -t-I�-��� L .�'e <br /> PLUMBING � MECHANICAL <br /> NO. TYPE OF FI%TI�RE OR ITEM FEE HO. TYFE OF EOUIFMENT FEE <br /> WATER CL05FT ITOILET� A/C—A/MNDIG UNITS—H P <br /> BATHTU9 REFRIGERATION UNITS—H P EA. <br /> LAVATOHY(WASH BASIN� OOILEflS—B.T U.�N P <br /> SMOWER GAS FIREO A G t1NITS—B T.U. <br /> KITCHEN SINN 8 DISP. FORCEO AIR SYSTEIAS—B T ll N.FA. <br /> DISHWASHER WALLHEnTEflS—B.T.LL M <br /> LAUNOFVTRAY �NITHEAT[RS—B.T.0 M <br /> CLOTHES WASHER EVAPORATIVECOOLERS <br /> URINAL CLOTHESORYERS <br /> ORINKING FOUNTAIN VENTIIATION FAN <br /> FLOOR DRAIN RANGE/1000 <br /> BACKFLOW PFEVENTERS WATERIIEATC-R <br /> FOOF ORAINS—RAINLEADERS WOOD STOVE <br /> SINK($ERVICE—BAR.ETC� 61ETAL FIREPLACE 8 CHRANLY <br /> � FIREPLACE IN5ER7 <br /> HEAT PUMP <br /> GPS PIPING <br /> [XHFUSTFAN <br /> � � � � (�OF_� �� Yr trl. EcSm diL <br /> Sl1B TOTAI f ' UB TOTAL <br /> PERMIT f PEflM1T <br /> TOTAIFEE S TOTAIFEE � <br /> uaur+r serunea �ienq se�eacn sm[se�nneK �'�.TN C11ECK Nl1M(3ER FEE AECEIPT NO. <br /> uscror�e iarnn�n yqfA!lISiIE FEES VALUATION FEE <br /> fJYf:i IING <br /> OUILDING $ <br /> fYPCO�GONSf OCCIIPA.YCYGROIIP 1lpO��WI'tIIH.UNiiS <br /> PLUM�ING <br /> s�zeo�tnnc uo or sronies r.ua occ .nno <br /> MECh1ANICAL � <br /> � <br /> OTIiER <br /> RRE SPRINNLERS REOUIRE� U YES [i NO <br /> STATE DUILOWG Sl1RCh1ARGE <br /> STATEENERGYSURCH4RGE <br /> �i�vi�c<trou_r.r, uv pirr�scr�ecneoar <rvn ror��ssuonc�or <br /> aueuc woares <br /> TOTAL ...�J � <br /> PROPF.RTY OWNERS ARE flE5P01lSIBLE FOfl DETERMINING ALL <br /> PROPERTY LINE LOCATIONS AND(iELATEO EASEMFNTS. <br />