Laserfiche WebLink
IheErerO�een + dPPLICA,�'ION FO�♦ �e��-c—refl <br /> ��TMaF CC) NSTRU��fIO�J � <br /> eve�ett PERMIT <br /> TU BE COMPLETED IN BLACK INK— PLEASE PRIIJ7 <br /> BUILDING DEPT. <br /> 259•9745 ❑ CONiBINATION ❑ BUILDING ❑ MECHANICAL � PLUMBING ❑ SIGN <br /> owuen inr.n nnoness � eitv zir / )(� mw�+e <br /> �J{ A-C ���-(�h� ��,� � � �� �lll� � �� ���,C'�l ��l�f �(�l'�� P4. �:I �['1 �'.� I-�lL`iC�� �7 °)ij- �� 'J���� <br /> ♦RCHrtELtOR0E510NER rnni� ooneos T cirv ziP vr�uue <br /> oErienn�eornn�c*cn M+anoanears urv zir r,�or+e ucc�+=c • <br /> re[cn�rncn�eounucron rnni�nnnncss cnv z�r rr�nne i.icrr��e. <br /> PIUMBiNGC�NtRAC10R MNLAUDfiE55 CRV 21P f��PHE lIC[tl:l. • <br /> /, � •]C'C'. t•• 1 0" <br /> ���i�)t.��er� l��ut���.�����i ��' ��(�1 5C L'�'Pte�Il��4l� ���Cl�/ UPlr��QdC`F-� ��J� �c��� r�D fat-�All �Zl�, <br /> ctnss o�wonK <br /> ❑ NEW ❑ ADDI710N �� AL7ERA710N ❑ REPAIR ❑ DEMOLI710N ❑ WOODSTOVE;FRPL.INSERT ❑ BULDING �7[LOCATION <br /> V�W AIION OF WORN ICOST OF 61P IU11AL5 PLUS LGOORI <br /> � (- � � JG <br /> DESLniBE WORN , „ ��� f <br /> /; ' l l.�_,c� c', �n� yo�c l, <br /> l ble"IZeC.�./� .��/ C. L�.. �� i.�.�..2 �� ..,. ,e< <f%L, C. Lf�.)c'..L.:> � D � �if; <br /> I/5E OF BUIlD1110 <br /> I HEREBY CER7IFV THAT I HAVE READ AND EXAMINED THIS AP� <br /> ._, PLIC�TIONANDKNOWTI-IESAMETOBETRUEANDGDRREC�.ALL <br /> �mn�ntscmm�or+orP�orea�n�s�ow�+oaowonnrrpc�vouncom¢s pROVI510NSOFlAWSANUORDINANCBSGOVERNWGTHIS«PE <br /> OF WOFlIt JJI LL BE COMPLETED WITH W!1Eth1FR SPECIFIED I IERE- <br /> ior_e�oc�_or IN OR NOT.THE GRANTING OFA PERAIITDOES NOT PRESURIE TO <br /> GIVE AUTHORITY TO V�OLATE OR CiWCEL TIIE FROVISIONS OF <br /> �'�i��� C��� � � ._�� ANYOTHERSTATC-ORLOCALLAWREGULATINGCONSTRUCTION <br /> OR THE PERFORMANCE OF CrJNSTRUCTION. <br /> �-- . -I <br /> �y,4y`!�%�� ��7"�'j,�t��,� SIGNATUBEOFCONTHACiORORAUTHOR¢EDAGENT DAIE J�•� <br /> ul�W�L1E�UL u� <br /> � �_�11N� x�J�.;L. �:L �l.e �`� ��°-ic�i1 ic�l <br /> PAOJEGT AOOi1ES5 RPPIICANiS CI1Y BUSINE55 LIC[NSE NO. <br /> .��0 � — � G�� �5�1�E.c� - � ✓PVc�.� <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FIXTURE FEE NQ. TYf E OF�OUIPMENT FF.E <br /> _� WATERCLOSGT�IOILEp �( '- ���iCOND.UNIiS-II.P_GA_ __ _ <br /> BATHiUB REFRIGERATIONUNITS-H.P.EA. ____ __ <br /> LAVATORY�WASH BfSIN� _ BOILERS-H.P_EA. _ ___ <br /> SHOWEP GAS HRED 0.C. UMTS-TONNAGE EA <br /> KI'CHEN SINK 8 DISP. FORCED AIR SYS7EM5-B.T.U. M EA. <br /> DISHWAS!{Eq WALL HEATEFS-B.T.U. M __ <br /> L�UNDRYTi7AV UNITHEATERS-B.T.U. M _ <br /> CLOTHES WASHEp EVAPORATIVECOOLEHS _ <br /> WATER HEATER CLUiHES DRVEFS <br /> UflINAL VENTILATION FAN _ <br /> 9RI�.:INC FOUNTAIN RANGE HOOD <br /> FLOOR Ofl�IN AIR NANDLING UNIT- C.F.M. . __ <br /> VACUUId BREAKEPS STOVE _ _ ____ <br /> ROOF ORAINS-RNtlLEnDEaS METAL F'IF7EPLACE R CHIMNEY __ __ ,__ <br /> SINK�3ERVICE-BAR.ETC.) WOODSTOVE/FIREVLAf,E INSERT __ ___ <br /> SUB 10TAL C� ' SUB iOTAL S ______ <br /> PEfIM1T S I L� � PERM1IIT 5 _ <br /> TOTALFFE S O 1 TOTALFEE S __ <br /> THIS PORTIO{'J TO 6E COMPLETED BY BUILDING DEPT. PERSONNEL <br /> Ff10Ni5EtORCN �f��ISEtDA;K SI�ESELBACh P1.4NCHECHNU1ApE0 FL�NCh[CKfEE <br /> F[E �CLCIPf110 <br /> USEZOtIE LOInpEA yqCANT51tE <br /> ❑YES 11N0 FEES VALURT�ON FEE � <br /> TYPEOFCONSC OCCUP41lCYGf10UP HO.OfpWELLINGUN115 <br /> BUILDING 5 _�_ <br /> SiLE G:UtOG HO OP Si0FIE5 IdAX.00C.�O/� �L <br /> PW�IBING <br /> h1ECI IANIpqL <br /> FIRE SPRINKLENS REOUIf3ED ❑YES ❑ NO <br /> OtHER <br /> PENI�LTY <br /> APPUGAIIQNACG OY I'L��ISGIIEGK[D�Y 4PPR.(Ofll`vSUNJCE�Y — ----- — " - <br /> TCTAL _L <br />