Laserfiche WebLink
i <br /> ' ��'>PLICATION FOR? ���,�„ �' � <br /> � ,".".`°."" CON $TRUCTION <br /> c�o. e <br /> everetf, PERMIT <br /> BUILDIN6 DEPARTMENT TO BE COMPLETED IN INK- PLEASE PRINT � <br /> 259-8810 <br /> O DEMOLITION ❑ COMBINATION (� BUiLDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNER M�II�UO�E59 CI1Y IIF P��ONE ' • <br /> (3 a rutc( ,Su�¢n �iunune.L.L 2304-5i/i .Sf fvnnoff 9rS'7O/ ��7y7yO-»/�. <br /> •RGHIIEC�OR pkS�U��ER <br /> M.a�ooaess Z ��"""` <br /> 33��-9z62 <br />' OENER�I CONIP�LtOR MeIL�OOf1E55 C�n' ZIG o��ONE 4GEN9E• <br /> 4ovde C�.ut I,« dGa Nvnthuu�e.if Gaaao.� l/2/7-GOfh Sf. A'.�. Lk. Sfevu�n, WR 98258 Np7�TN�il24L( <br /> MkC11tN�f.�L COHIH�LIOq M�IL AOOf1ES9 G fY 21P P�IONE UCEHSE• <br /> PLUM0n10LOH/n�G10� M�IL�OD�IE55 Clrv 21{• PIIONE IICENSE• �� <br /> CL�950�WONN I <br />. � NEW ❑ ADDIIION ❑ �LiEf7A7�ON ❑ REPAIR ❑ OEMOLI�ION ❑ WOODSiOVE/FRPL.INSERT ❑ BUILDING f7ELOCATION <br /> � WIWIIONUIWpR��COl�OfMAI[N^/d5PL119LAHqp1 � <br /> �/J��� ~ Q(� �Z.`� ' <br /> `� bwy� <br /> OFSGAiUL wUOn I <br /> 2� X 24 �iQnQee <br /> use or eu��o��+e I HER[BY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- � <br /> �iartar�.e PLICATIONANDKNOWTHESAME70BETRUEANDCORRECT.ALI ' <br /> LEO�LOESCRiPfIO�IO�P�UPEnfviSnOW�iOELOWO����ACMiOUPCOP�E51 PROVISIONSOFLAWSANDORDINANCESGOVERNINGiHISTYPE <br /> //O OOO/�'O✓ -'�G � �SE %Ul� OF WOfiK WILL BE COMPLETED WITN WHETHERSPECIFIeD HERE• <br /> io�—eioc�—or IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> .. GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />. , � EG/o^-� ��� ��`� D�V, NO. Z QAT�EP RFORMAONCEOFCO STRUCTIONNGCONSTFUCTION <br />� • SI�f1AlU�EOFC Ifl�CTOfiO�AUIHOf11ZE0 ENI 041E <br /> A �_-Gi� <br /> •PI'LIGNL'CIfv0U51NE55L�G ��SENO <br /> . PPOJEC�AOUHE55 <br />' �m� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WRTE�CLOSET�101LE11 AIC—����NOlO UNI TS—N P <br /> ' f1EFRIGEf1l.TION UNITS—N P.El�. <br /> BI1THiUB <br /> LAVATORY�WASH BAS�NI DOILEf15—B.CU M P. <br /> ' SHOWEA OASFIPEDA.C.UNITS—B.T.U. <br /> � NITCMEN SINK 6 D�SP FO�CED A�f7 SYSTEMS—B.T.U. M EA. <br /> � WAILHEAiCfiS—O.T.U. M _ <br /> OISNWIISHER <br /> LAUNDRYTRAY _ <br /> UNIT HEA,'ERS—O.TL. M <br /> CLOTHES wASHEn EVAPORATIVE COOLEFlS <br /> CLOTHES DRYE(75 <br /> U�INAL . <br /> ORINN�NG FpUNTAIN VENTIIATIQ';FAN <br /> f�pO�i O�AIN iiANGE HOOO _ <br /> OACKFIOW PPE�ENTEfiS W�7Efi HEA7E� <br /> f100F Oi1111N5—��INLE�DERS WOOD STOVE <br /> S�NN�SEfiVICE—O�f1.ETC I MEfAI FIREPI.ACE 6 CIIIMNEY <br /> FlREPIACC-INSERi <br /> NEA7 PUMP <br /> � GAS PIPINO <br /> E%hIFU$T FAtJ <br /> ' SUBTOTAL 1 SUB TOTAL <br /> PEfIMIT f PERMIT <br /> 70T�LFEE 1 TOTALFEE <br /> I PLAN CH CN NUMBER FEE � � �J RECEIPT NO. .../// <br /> iuplll$FIOef.h IIC�VISEI�ACN SIDESEIp�CN � � /1 ��L11-� <br /> �J .' � �o � � �c����� qC l J <br /> �} <br /> ust tuiit � io�nnee ��������iiE FEES VALUATION FEE <br /> Q� � ❑Y[S O �/�� � <br /> �� �'�'"' � BUILDING S �-�j.� , <br /> �t�'E Of�p;15f OCf.UPnNLY r,nour ��0 Of�WfLLIHG UNIIS <br /> / — i'WMO�NU <br /> _�—/4 <br /> s�zE��� moo p��., ,y i�o ���-s�omes Mnn occ iono MECFIANIC�L <br /> Z°YZ�{ 1'1'Cl� W <br /> on+en <br /> i <br /> fIRE SPqINKLERS fiEOUIREU [7 YES �NO $TnTE BUILDING SU�CH�t1GE <br /> STnTE ENEf7GY SURCh1ARGE <br /> •nviic<nor+�cr, o• rieu,a�eeK[UB� AI'f0 (01115511�NGEBY pUBLICWORKS <br /> � � �— \ TOTAL �, � �- <br /> �U �cY�l <br /> pf7pP[.fiTY OWNEf7S Af1E f1ESPON5IBLE FOfi DETERMINING ALl <br /> � PROPER7V LINE LOCATIONS AND RELATED EASEMENiS. <br />