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• l.U:�'� ! t<�;�. i iIJIV <br />� � �'�C:1�►i'r APPLlC,�TIC�N ' <br />� COMaINATION • f3U1LDING • MECIi/1NICAL • PLUM[11NG <br /> JNNIH MNLAUUMIii�l ' LIY Y�IUNL <br /> � 1 _,_/ <br />� �K.�7r.2E,'_�.�� {�ca'il�) )��A.c'� ✓ L � .�F�x.��3� f��c'�cc'i[ r.L� � �'��3 35�� –�`{�j� <br /> , <br /> A CN�iLCT U11 ULSI(:Nkft MAILADUflt51 OHO LIGkNSk NU. <br /> 16N�' `y���.��_ <br /> C�LCOTTIInGTON MAILAOONESS � �MONE � LICENtiENU. <br /> �dECHANICAICONfRACTON MAI�ADOflE55 PNONE LIGENSENO. � <br /> `IVMUINGCPNT,RACTON MAILAOUftE55 pHONE LKENSENU. <br /> 'EfIMIT CLASSOF WONK � � � <br /> ❑COMBINATION . ' . <br /> QOUIIDING �PLVMOING �MECHANiCA� aNEW ❑nDDIT10N ❑l+lTF.fl/�IIUN- ❑NU'/��fi <br /> 'ALVATION OF WORK !l <br /> j� I �OEMOIISH �FENCE ❑SIGN uSWIMMING VUOL <br /> •ESC�6E/WORK ' �� - <br /> Cjr'�(� � - � �L <br /> � <br /> Roroseou � OTtIERPERM.ITS ORAPPROVAIS <br /> G' _ j� RE ZONE �( SPECIAI USE <br /> EGAI U6iCRiPT�ONOF VROYEfiTI" fS��OW UELOW Ofil�TTACh� <br /> ou��e�ov/iJes� y�^/ .. �.VARIANCE � SF'ORLINE <br /> j,OTL_Y�-BtOCK�OF!.�L�� �� ���� � <br /> SEPA CHECK L�57 REt]UIRED <br /> �` �' I�' Y E 5 <br /> �V���n�v �j, � NO � . <br /> �e nooaess <br /> �y3� �y���,� �JuF o['✓sn.efj<< t.�/f� 9�2oj !MECHANiCAL <br /> LUMQING ' TYYE OF ENEHGY - - <br /> . . ❑t:A� ❑ELEC. <br /> � . NO. __ ___ TYPE OF F�UIPMENT � FEE <br /> AI R CO^JO. Uw1T5-M.P. E n. . .�..-_-��_FT S-"----�'-- <br /> - .__"-_ _ ._-"" . ..______ _ ___Y�_ <br /> :O. TYPEOFFIXTUHEORITEM FEE NF<<i�GEa�T��r� uu�rs ��.V_F.n. _ ^____� <br /> - __'"_ ...._-_-". __ "' _ . <br /> HA1H TUtiti 9---�r_-- --� OOilFRS H.P EA. _ __ _ " _'"_ __ I <br /> . _ CtOi_iCSI'J45HFft _�- r • - -__'_— '__._. _.__.______1- _—T"-- <br /> LURCED AIR SYSTE�dS I4.T.U. �EA. _L__, <br /> U1SIT YIASHFH$ -- � � ^ 1 <br /> OHR.r:irir riJUr�7n�n:s - --'- -�--�-- <br /> �. --'—'-' $PI�CE t. lYAll ��EA1FH5--_Fl.T.V. .___ _______j.�,_ <br /> FlO_)H pHAlt:$ �-�--- UNIi HEI�TER. H.T.V�'��_ I <br /> K1IO�rD!tilrvr;5 !4 i)IiV. i - -__--_- _--"---_' -T <br /> -_UANSIf1K5 � EVl�vONnTrvECGOLEHS______" ____�___ <br /> -- VlpOP Oii�iP:$ R1W LEAULRS ' _?-- _ CI.OT��ES U�tv[�5 __ �.__'_T__ <br /> - - �'-�—� - _ VCYTILATIpN(AN � ��_� <br /> . SFIiR`:ER E:,:TIiS __ J� "-- <br /> $ElIVICE $I�IK$ _� _ t N.NI�E ��000 __ � <br /> - -__-.___-_" - -1�..' ___ ___-_.- _. -- - ---7'_�. <br /> SUYVb \-W1GF. VU^4P __"_ �-_ niR H�NUUNC UNIT C E N _, __ „y__� <br /> " _ . _ . � '__" ' _. _ ._.._ . . ... . <br /> U���'�ALS _ _ � <br /> � WNER ( 10 E.iS � . _ .___ _� . . . '7-- <br /> � _". <br /> � YfATEFI IIEATER . . --�-�-- <br /> R'ATER ! f ��rEnS_ - [L[C1RIC - - <br /> 17AiH 6:�SINi ' � _ _ FAG OVIIT FIREPLPCC W CIIIMNLV '_i .. __-T�_� <br /> L�1l1NUtiY i RAY$ _ GAS. 5'/ TEM_NO Ov pUTlt 15 �_ <br /> L-- . - � .Un rotn� 5 I <br /> � - vERn� i S -_f' <br /> � ' --'�--�--- iF,inttkE 5 � <br /> - ---" SU6 TOTAL � TMIS YFln.ii� 6EC0'.�Ei NUI l. nrvD vO�U i� �Yun✓. nn CUNST9UC <br /> PERMiT . __ 51_--T-� 1iOrv nVt��OA�L[D �5 NOi C(r\•�r.�INCfD wrt�uv 1±00.�v•:. n� �F <br /> lTOTAL FEE 5� � CONST(�VCIiON OA �'JOHK 1!: :SU:.�'PN[)[[) GR !�lII�NDO��ED fOit 4 <br /> .TEf1 $FRV�f,E $IZE_.__HlOG. SUPPLV $IZE V[f1tOD OF 1]0 DAvS /�T /�N� f�Mt /.�TC�iwO��K �`•CON'.+fNCkb. <br /> -! 1 IICR6fiv CER1'IIY 111,11 114�`/t IILAU Ann C`fNliNln ����: Ai <br /> JC Yi�F ilfl\C'n��.7HP��[TtlACK�r IIGAiIVl�RUSfifMP.� PUCATIO>1 AND KNOW TNE iAb1E TOHC TfiVE fWDCOHIiIf_T. All <br /> � PROVI`.�UN; OF L.1Y:5 nhU Oirt��YM1M1tES GfN[RN�hG ���i5 TVVE <br /> . OF WOHK YIILL BE CO`.SVL�fD YAtH Y:��ETHLR ::vECIF�L:J ��[REtY <br /> . .IIUNk ___-__ 101Ai11A VAUN(Sitt ^-.': UVEOnUi�iO���TY i01dtOL,nfE UH(+CnN�IE:I�EOv�aUV�ti�OrCi OI <br /> � ' ❑YES �NO : ANY Oi1�Fvl SiATF On LOIn� LnW 11fGULATIN�i CON':iRUCT10N <br /> Of� inE VE��FOAM/�NCE Of CONSiHVCl10N. <br /> �VE OF GONST OCCUYqNCV (:fiOVY h'O.DF OWFLCW(: �1 • <br /> UNi15 ^ //�� <br /> � � / � <br /> /_E Of flLDG. NO.O� STORIES Mna. OCC. l0/�D / ' <br /> x �' � -- = /y 1.�' <br /> � 51 �l� VftEOFCO TFlnCiOflOHI�UTfI./�GFNT OA E <br /> ;tlZON6 ���-` IIA:{lMIN) I11:1_`:PN�HKLUIi ������.�...�..�s-� �c+�o°"' <br /> � � HFOUINEU i'L.�nCHICKNVM1WLH PLI�.`lCI�ICl: IIE <br /> . ❑YES ❑NO fLC . 11ECEIf'f N(�. <br /> tGAI CONUinOn:: _ _, . - <br /> _' "__.a'� � __ _ . _ . .. . . . _ . . .. . <br /> ' ^FCES --' VAIUA(1'ON '__FF.E <br /> _ — -- _—�- � , -�- <br /> -�-t-_. <br /> _.__"-_. _ ".___ __.- '- .� <br /> .---- iw�io�Nc s i ,. �' --� �Pc <br /> ' � . '—_. _ ._f:�.' �__-._" _ ' .r'_-_ <br /> � <br /> �EPA REVI[b`,' COMPLET[ � ❑YE$ ❑ NO • P��'MmNu _— � . <br /> � <br /> ConloCf ' rsiC��nwrni ' � <br /> planninq dapL ��_... - <br /> - . i <br /> . � . 0711CP � <br /> ____'_"_._ .M - __ <br /> ..SEG. ]071�1 � <br /> �ubuw�«vi���e, r�,.r,�yu�����r ♦nn�v�o on�y�i�.wl�� PENAITY L,_ <br /> ___� �- <br /> �.' _�' __��...� . __�.�. _� <br /> � 70TA1 l�' � �� <br /> . � _ _� �.�...�1 � T <br />