Laserfiche WebLink
APPLICATIC �1 FOI� CON�TRUCT' 1N PERMET �✓� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRIIJT <br /> � HEATING SYSTEM ��GAS � J ELECTRIC J _____._� <br /> 3"'LDING DEPARTMENT — -- <br /> 259-8810 <br /> I I DEMOLITION CCMBINATION _�( BUILDING xMECHANICAL �PLUMBING SIGN <br /> OYMEF �Ail R0�iCFS [I1V )iP °NONE <br /> �ys��s �NS�- ,,,�, �..� zzy ix��"sr��� �3_.a� �s��? �yz - 49z2 <br /> rE �fHrry . 1�' IUSCOV DURES''IS 5 I 4 W ZJ""�L �U�I Iti4J VVe. r��on[ �_ _L <br /> A1 � �----- �7zz� ( - so �zs-9/G- <br /> �RLMITEGTOROESIGNEN Mr11l�DORE55 Cii1' Zlo I�HONE <br /> NEfiPI.C9NiMCTOR I�AII�ODHE55 Ci(�f 2C PHONC S�ATEU NSE� <br /> � < CI CO I'N(,��0 T Zz� l�� `-��_��g��s�'o��?�yzz �/s���c� <br /> �jiff UNv'R�CTOR �R� DRE-�65� C�' liP PHUN[ STQELICENSF• <br /> 71� l�PVI 11/1�1 — <br /> PW.'9iN4 NTR�CIOR IIJ �RE55 CIiV ZIP PdONE SiA1ELICENSC� <br /> 6 ;�s a���rhti , _ <br /> �c tn�cT rruceqo!r�w / �'''�7� � <br /> c�l U � l �W�'•_ . <br /> OESf,RIPFWORN�ND50UAFEf001�GEINVOIVF -� CON1�CiPEf150NpNDP1�ONFNO � ��� _ �G�� <br /> �.�.JISTJN I:V1 O�1WJ �� V) � Al Z�L) �7`� I�� Sl-,J ��e��� �/ 11d���2.. <br /> � � i( (�. 2�3s 3 � i HEREBV CERTIFV THAT I HAVE FlC-AD AND EXAMINEU THIS <br /> PR voseo u OF BWl�INO � APPLICATION AIJD KNOW THE SAME TO BE TRUF AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVEiiNING THIS TVPE OF <br /> � an�v�scnivnor+nr rnoreniris�owr+ee�owoa rac ��Pic. �� WORK WILL BE COMPLETED WITH WHETHEA SPECIFIED HEREIN OR <br /> -y NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �oT� �1OCN n ,�n oP ' AUTHORITV 'O VIOLATE OR CANCEL THE PP SIONS OF �NV <br /> F� NOl I �I Q� V�r( �'N 1 N� �iS OTHER STATE OR WCAL LAW REGULATING CO TR CTION OR THE <br /> 1� � q PERFOHMAMCE OP CONSTRUCTION. THAT I A AVT RIZED BV THE <br /> �JJ��'.� - I P5ti1 '"�7 I 'J��j � /I _ OWNER OF THIS PROPERT RFORM HE W RK FOR WHICH <br /> APPLICATI IS MA - AN I COMP V W H THE STATE <br /> vnaeei teK i o nu��nen CONTR OR LAW 18 7 R AND 29fi.200 <br /> CONSLFIIC�i°�LORN1hF^ND R �D FESS.Tt�E/PHONENIII'flFf�� J? <br /> '1t'P Y„�� �o7Llo ��'+�jM�N�i�Z �uf�r g> --- --� � � ._ <br /> oR0 ADDRESS � ' C - "„"" __ °•16_ — <br /> �7 ��.m�����vu;si.,�H�;i n,� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FU(TURE OA ITEM FEE N0. TYPE OF EOUIPMENT FEG <br /> r <br /> \'d4TER CLOSET(TOILET� ' A'C-AMNULG UNITS-H.P. __ _ <br /> ��, BATHTUB � � � FORCED AIR SVSiEMS-B.T.0 M E.A. � -~ <br /> LAVAT�HY iWASH BASIN� UNIT HEATERS-B.T.U. M _T <br /> SNOWEfI �� C'_OTHESDRVERS � <br /> HITCHEN SINK 8 DISP � �'ENTILATION FAN ' <br /> DISHWASHER / � HANG1.HOOD � <br /> LAUNDRV TRAY i ; W:TER HEATEfl ' ___ <br /> CLOTHES WASHER � -� WOOD STOVE __ <br /> UPINAL ' MET4L FIREPLACE�WOOD BURNING <br /> DRINKINC FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP _ <br /> BACKFLOW PREVENTERS GAS PIPING �' " <br /> HOOfDPAINS-RAINLEADERS �— EXHAUSTFAN ��� <br /> SINK(SERVICE-BAR,ETC.) _ — <br /> _ — -�— <br /> — ___ '-'�. _ — <br /> ---—�— <br /> SUB TOTAL E __ __ SUB TOTAL $ _�'Q, ^ <br /> PEaMIT E PERMIT S <br /> — '---- - TOTAL r:.E g — -- - �---�- -- TOTAI FEE - $ — <br /> FOR OFFICE USE ONLY: <br /> fRONTSETARCK PfABSfip�G��// SI�ES[�iPI�f� �"�9(��ECNNIA�PF� if:l �� �fffl�iN�i <br /> � � I� ry4� �7 � ' � �� J�' "-' � �� .- <br /> useiw+e LOT�REr V�C�NfSITE FEE5 VALUATION FEE <br /> �+I _ � VES NO BUILO�Ni �1 _ <br /> IYPEOlCONSt Y�OfSLOq�ES �2ru�. xnn�nv.t �...�.��� ---'---- --- ���1 S�� ��(� <br /> �,-'r .J ` �"3 __,_- _— PWMBING _ _�1L�— <br /> Siz� I iIRESPRINnLER5RE00 B45CMENt MFCHANICAL �fr)� <br /> '13vP �% 1' � � � YES ✓hC i- <br /> sro s. r.� 1� —_ ----- l� ,�— <br /> OGCUP�NCV LOAD fiRf ALANM RF.00 R[IG��t LIMIi�T`ON ADDITIONAL PLAN CHECK i <br /> _�P . - — ��-_ —�)DD --- -- �-�- <br /> REASON <br /> �� �Y,� 1� a�� STATE BUILOING SURCHARCE __ � �_�� <br /> 1GKiT�� (/�t.��/��f��'_ _ <br /> i 1nKEBv riMr,m'runvtunr CIIYOFEVEAETT PUPLICWORKS GU� <br /> J{-} LOCAL SALES <br /> on�r , �y �3 TAX CODE IS 3105 TOiAL ZZ �"7 <br />