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Ih�EraOrNn . .PPLICATION FO.. � ���,�„ <br /> ��n�f CONS . RUCTION 0 <br /> eV�I'ett PERMIT <br /> f'�'' DING DEPARTMENT <br /> 259•8745 TO BE COMPLETED IN INK- PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION tl BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNER J MAILMpHE55�/ GIiY 2iP PIIONE <br /> ,+ .tiC�ra-�n�.�'o ' /`.1��A �. 1 <br /> :.'L�L7_'�.0 `/,7_2� /< lC'Fy t.i'r'�r'.�I� <br /> f�1RLNrtELtORDESiONEN Meq�00RE55 CIfY Ziv Pr�ONE <br /> f R,` �c�y;��aiJ 4�/ T'A t'`1 •]'9 . �f.-�7'i t• .� -'�if.(.S 6�S� <br /> O[�LCONiRACiOP MqL�0�11ElS CiiV DP pl�OUE LICENSE• <br /> I�Cn('�EP T> �c:�.c. f _/.tC:. zazrC «�:�._r ��� �t1r� L���.� :c:,. Q9�7Z 7%9-�G4.5- �cr�i"r i��' i���/1/. <br /> MECNI1NIUlCON1ReGiOq MeILA0DNE35 �� LiTv 21P PIIONE LiCENSC• <br /> O�VM9111pCONIR�CiOA M�IL��DOE55 CIiY 21P PIIUNE Lll'fN51: • <br /> �L�SS OF WORN � <br /> ❑ NEW ❑ ADDITION ❑ AL7ERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ItI�BUILDING RELOCATION <br /> V�L W1�ON Oi W9l1N�C091 Of IAdtERU1.5 PLUS UBORI <br /> �� , <br /> '�S /l�5 = <br /> �ESGRIBE WORK� <br /> j ��, C.f . It�: I _ <br /> use or em�oir�o <br /> I HEREBY CERTIFV THAT I HAVE READ AND EXAMINEO THIS AP• <br /> �[•i"�.� PLICATION AND KNOW THE SAME TO BE TRUE ANDCORRECT.�LL <br /> lEO�LDESCPi�IONO�vROPERfYiS��bWN9ELOWOR�ii�CMfOURGOPiE51 pROVISIONSOFLAWSANDORDINANCESOOVERNINOTHISTVPE <br /> OF WORK WILL BECOMPLETED WITH WfiETHERSPECIFIED HERE• <br /> �or_e�oc�—or_ IN OR NOT.THE GRANTING OF A PEFMITDOES NOT PRESUME TO <br /> OIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> ' OR THE PERFORMANCE OF CONSTRUCTION. <br /> I SIONATUFE OF CONiRA�TOR OR FUTHOPI2E0 AGENT 041E <br /> � X �(.�1�i/((Il.i�l� 2.z-�% <br /> PROJECT�pDPE55 APPLIG Ni5Cl�9 S�NESSLI .ENSENO ^' <br /> ' � u��?� — � � ��� <br /> PLUMBINO MECHANICAI _ <br /> NO. TYPE OF FIXTURE FEE NO. 7YPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) AIR COND.UNITS—H.P.EA. <br /> BA7HTU8 REFRIGERAiION UNITS—H.P.EA. <br /> LAVATOflV�WASH BASIN� BOILERS—H.P.EA. _ <br /> SHOWER GAS FIRED AC.UNIiS—TONNAGE EA <br /> KITCHEN SiNK 8 DISP. FORCED AIR SVSTEMS—B.T.U. M EA. <br /> OISHWASHER `NALL HEATEPS—B.T.U. M <br /> LAUNDRV TRAV UNIT HEATEFS—B.T.U_M _ _ <br /> l"IOTHES WASHER EVAPORATIVECOOLERS <br /> WA1ER HEATER CLOTHES ORYERS <br /> URINAL VEN�ILATION FAN <br /> DRINNING FOUNTAIN RANGE HO00 <br /> FLOOF DRAIN AIR HANOLING UNIT— C.F.M. <br /> VACUUM BF=AKERS STOVE _ <br /> P�JOF DRAINS—RAINLEAOERS METAL FIREPLACE 8 CHIMNEV <br /> `iNK�SERVICE—B<.R,ETC.) WOODSTOVE/FIREPLACEINSERT <br /> SUBTOTAL SUB TOTAL ! <br /> PEfiM1T f PERMIT 3 <br /> TOTALFEE � TOTALFEE f __ <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> RiONi5E1p�CN REA�SEIBAGN SIOESEIBRCN PLRNCNECN%UMOER `� � � ' r('PIANGRECNfEE r /' <br /> /1Io�./E �� /r r�=T� - . a • �] 7 7 FEE� G��J RECEIPi N0 X z5L'I„ <br /> USE IONE l0����F6 V v p� <br /> � i V�C�NI SItE FEE9 ���U�TION FEE <br /> B-2�} i�� ►7e �.Es��,o -- <br /> tYPEOfCONSf OCCUPa�ICYG�OUP NOOFDWELIINGUHIIS <br /> ,jL -N �?-Z O ew�oiNc s$'�Co'S. S� 60 <br /> 54E OF BLOG HO Of SIORIES MA%�.yOLC.1040 — <br /> ZO Z p I I j� iYl/�/. �'LUMBING <br /> 1p�2�'hpp, IF1G.L Ifl %lJ�j C,, MECINNICAL <br /> FIRE SPRINKLERS REOUIRLU U VES ❑ NO -- <br /> OTI/ER <br /> PENALIY <br /> a�PIILAIIONRCC BY PL��15C11ECNE0BY RPP0.FORISSUANCEBY -- <br /> TOTAL <br /> ��� h� /i„� L _L -- <br />