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HomeMy WebLinkAboutPermit Mechanical 2004-2-3 sPi=i~NC:?~::ELXli ...-' ' ~; City]obNumbcr &1-0/ /7j- o LOCATIONOft'.Oro;EDWORJO (o5;'bZ E si. C :~~ORS~ . ~~ OWNER: 'T oh" Lf)V-e (I 0 ~ 10M, ' ~ ADDRESS: {p S' 82. ',E: _$~I rJ1 crIY' c,p V' lV1 ~/'t e IJ!; 0 (2 ~TAT" ( ~i t)(scRIf'I'ION or WORK: Wt2f2/ ,,0-.; ve... / VL.<;e-v+- 1";""~"~-~'~ Nf.W: V RLMODEt: ~j O:t'.'.: :. f GENERAL: SfnVlj'h'<;:fci lOR q-; l./Oz- TAX LOT: PHON!:: 7'-1(~ - wS9<f: t. 012 " ZIP: ~7' 7L/7f< .. wotTON: OF.MOUSlI: OTHER: VALUE: t. C.ONST. il2q L{ CONTRACTOR'S NAl1t ADDRESS CONTRAHoR # EXPIRES -Y(~ J!{yJ 1l~llLVl S'~ \ 4~) lie: I Zo LUAJ I W YjL ;S-u~()0< PHONE 43/-02ct:) CC2!J07 PLUMBING: MECHANICAL: LLLCl'RICAL: MECHANICAL PERMIT PLUMBING PERMIT ~' \ -.._.~._;i , t,,~! .," :-t--... . '. . n:EM FEE ITEM FEE Furnace Exhaust. Hood Vent Fan "No. ' __" _ Wood Stove/Insert/Fireplace Unit V JJ; ., FlXtures Rc:,'idetttial BaLh(s) No. ~itary Sewer IT. Water Fr. Storm Sewer IT. ~: Meehan;"" P<rnIit SubloW U SUf<=~$45.00 Administrative Fcc 10% ~ "-'<. r.. " 1 ! ;-'" { TOTAL MECIiANlCAL . \ JI,. 4 s;:e... ~ :s- Flumbin& Permit Subtotal ~~Minim.um of $45.00 Sf-d.te Surcharge 7% Admizmtrative Fee 10% TO'I'AL PLUMBING 1);; .';; ~~ -0: '~ .~ ,11tl~~, fl'\1rn,0rr . ~. J.~_~.~~~ , ,~ N~ J.~, , - ...~~! ,,' - - ',' , '~1~IS'~;: .,~~n:~Afl,11:1::C~ ~., .r".~~.1J ..;~Q: ~:, ~~~~,\.b~~ Sh:ucd Drivc(T:)lll\Iildi'll; l'onnslPtrmil W~l3004.cloc