Laserfiche WebLink
� . ...,. � ii� . � ��. . � . ..�.. . . � _. <br /> iNEvupreen A. PLICATION F�Di2`�� CVef1„ <br /> °�n°F CONS�RUCTION � <br /> ?vere�t PE RM IT <br /> BUIL.DING DEPARTMENT <br /> 259-8745 TO BE COMPLETED IN INK - PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING O MECHANICAL O PLUMBING ❑ SlGN <br /> 1�OWIER MAILAOORE55 CITV ZiN p�lpll[ <br /> 2.b� 1�- � �'�r I l 9 ��6 Y 3�-d �4ut 1�1c= a (.�I. `I*,'a:�_3 �. 59-G �97 <br /> npL1luFCiOR0E5iGN[fl MAILe0DP655 Cltt ZIP P��O�IE <br /> GEN RAL WNiNALiC:� MAILAOOf1E55 f,iiY :'? p1101�E iICEIlS[• <br /> � ..e rc, ll �� z � �l �'"`�NUr IU�=. G�'I . `i� � � 3 (r� sy-��v� ���bec 15S1(i, <br /> MECNANIGLCONTR4COq MaILA00PE55 CIIY 21P PHOI�F. uL[I1S[� <br /> P1U1.16WCCONTR4Ci0R hUILApOBLSS CIiY IIP PuOu[ IICBlSI• <br /> Cl n55 OF W OflN <br /> (�I NEW I� ADDITION ❑ ALTEF.4TION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ Bl11LDING RELOCA710N <br /> VA W 4ilOR OF W OqN�LOSi OF MRiEf.lAlS YLUS L4BOF1 <br /> 53 vUv °� <br /> oesenme� on� <br /> l�e �) ��e �yc� �¢ �l G-�� <br /> use or em�oum <br /> I HEREBY CEFTIFY THAT I HAVE READ AND E%AMINED TIiIS AP� <br /> UU �. PLICATIONANDKNOWTHES,4METOBETRUEANDCORRECT.ALL <br /> LEGALOESCflIPT10NOFPROPERLY�SI1DWNb5LOWOR4RACHPoUflCOPIES� PROVISIONSOFLAWSANDORDINANGESGOVERNINGTHISTYPE <br /> � OF WORK WILL BECOMPLET[D WITH WRETIIEFSPECIFIED HERE- <br /> ior�o�oc�oF 5����'' � �-�K e U l S�� �N OR NOT.THE GRANTING OF A PERMIT DOE-S NOT PRESUME TO <br /> GIVE AUTFIORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUGTION <br /> OR THE PERFOP`.'ANCE OF CONSTRUC�ION. <br /> swNn.une or cor�inacrur�on nurnon¢co nce��r oare � <br /> PRO IEGT AODflESS RPPLICANiS LITY DUSINE$5 LICLNSE NO <br /> /��/� "t�� J c <br /> PWMBING MECHANICAL ___ <br /> TNO. TYPE OF F�%TURE FEE NO. TYPE OF EOUIPMENT FEE <br /> .L WATERCLOSET�TOILET) IU AIPCOND. l1NIT5—H.P.EA <br /> BATHTUB ,� REFRIGERATION UNITS—HP.EA. <br /> LAVATORYI�VASH BASINI OOLLERS—H.P.EA. <br /> � SHOWER GAS FlHED A.C. UNITS_70NNAG[EA. �_ <br /> � NITCHEN SINK 8 OISP. _ FO(iCED AIR SYSTEh1S_B.T.U. M EA. <br /> � DISHWASHER WALL HEAfERS—BS.U. M _ <br /> LAUNDRYTRAY UNITHEATERS—�S.U. M <br /> 1 CLOTHES WASHER EVAPORATIVECOOLERS <br /> �/ WATER HEATER CLOTHES DRYGRS , �_ <br /> URINAL Z VENTII.ATION FAN __ � �L� <br /> DflINNING FOUNTAIN RANGE HOOD (> '�� <br /> FIOOF OflAIN AIR HANOLING UNIT— QF.M. <br /> VACULIA7BREANERS STOV[ <br /> ROOF DRAINS—RAINLEAOERS METAL FIREPLACE B CMIMIIEY <br /> SINK!SEFVICE—BAR,ETC. WOO�STOVE/FIREPLACE INSERT <br /> � –4414'�3inNcx.��— `� <br /> SUBTOTAL SUBTOTAL S <br /> PtflMIT S PEflM1T S <br /> TOTALFEE 5 TOTALFEE f <br /> TElIS PORTION TO BE COMPLETED BY BUILDING DEPT. PE�SONNEL <br /> 1'RONi5Ei0nCN PEAflSElOACH SIOES/[T�RCK PLANCHECNNO�IpER N51lCIIECttG[E <br /> _..b-C� f �l� 1 l�rl ' (J� ��l � GEE �����D R[CG�PINOpI/O �L{.--_ <br /> USE IDNE lOi AfiEA ` <br /> � V �NLSII[ fEES V/WNTION FEL' <br /> _ I ES ONO <br /> iYPEOFCONFT OCCUPANLYGPOUP NO.OFUWELLINGIINliS <br /> U �\� �� ' " I BUILOING f /A// L - `, <br /> SIZE OF pIOG NO O!SiOfIlES MRX OCC LOAp �' " 1� ��• �-n�° <br /> L13Cp {�'� I PLUMBING ����(� <br /> MECl/RNIGAL J '� ��� <br /> FIRE SPRINKLERS REOUIRED ❑VES ❑ NO — � S-(?- <br /> OTMER /� 0-�� <br /> PENALTY i J ry Q <br /> APPUCqT10N1CC pY PL�NSLi1ECKEDOY RPPR FOflI55U�NCE�Y - <br /> TOTAL ��7 D� <br /> �I,M , J5 — <br />