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� ;i�c Ere�aree,-i <br /> � ��T� �F CONSTFiUCTION ever��tt <br /> � everet� PE�;M�T 1 <br /> � ��,. ,,,.<< „o _ <br /> �:��t,. �:w..,��,`.: <br /> � 9 � 3UILDING MECHANICAL PLUMBING � <br /> ;��ivr.or�ov:�er.�.n <br /> o[vnm��.,�.i <br /> OWNER MAIL4UDHE55 ZIP PMONE <br /> i�a��p 1�e�s'aoE �3A 1;t�oodu�y 9�, 299 P4�(s7 <br /> ARCHITECT OR DESIGNER MAIL AD�RES$ PHONE UCENSE ND. <br /> GENERAL CONTRACTOR MAILADDRESS PMONE LILENSE ND. � <br /> � <br /> MECMANICAL CONTRACTOR MAIL ADDqESS PMONE LICENSE NO. <br /> PLVMBINGCONTHACTOR MqILADUflE55 PMONE LICENSENO. � <br /> W <br /> � <br /> PERMIT . CLASSOFWORK ? <br /> �y � <br /> �]6UILOING � PLUMBING ❑MECHANICAL <br /> ❑NEW ❑AD�ITION �ALTERATION ❑REPAIR �- <br /> VALUATIOIJ OF WOFK <br /> 5 ��� ❑O[h10LI5H ❑F[IJCE ❑$IGN ❑SWIMMING PUOL W <br /> DESCRIBC WOqK � <br /> �bail, u�v ibc�4ing sact vaSl at ��sa� $21 <br /> PROPOSLU VSE <br /> (,� � � MECHANICAL <br /> TYPEOFPUEL �OIL �NAL ��PG. �ELEC. <br /> L!_GAl pESCRIVTION OF PfiOPERTY ISHpW 86LOW OR ATTACH GAS <br /> l.or���oLOCK�oF� � _�� NO. TVPE OF EUUIPMENT FEE <br /> NFi CON�. UNI75-H.P.EA. S I <br /> REFRIGERATION VNITS-Ii.P. EA. <br /> — — 601L[RS-N.P. [A. � <br /> GAS FIREO A.C. UNITS-TONNAGE EA. <br /> FOFCEO AIF SVSTEMS-B.T.U. M EA. I <br /> JOB��O�i ^F,�,$ ._ WALL iiEATERS-B.T.U. M <br /> '���� �� UNIT HEAT[FS-9.T.V. M 1 <br /> EVAPORATIVECOOLEFS <br /> PLUM8ING CLOTIiLS ORYEPS <br /> I <br /> VENTILATION FAN <br /> RANGEHOOD � <br /> I NO. TVPE OF FIXTURE OR ITEM FEE �+IR HANOLING UNIT- C.F.M. <br /> WATERCLOSETITOILETI § INCINERATOR � <br /> I BATHTU9 <br /> I LAVATORV(WASNBASINI � <br /> SHOWEN <br /> I KITGHENSINK & DISP. SUBTOTAL $ � <br /> i OISHWASNER PERMIT S <br /> i LAUNDRVTRAV TOTALFEE 5 � <br /> _ CLOTHESWASHER THIS PERMIT 6LCOMES NULL AN� VOID IF WOFK OR CONSTRUC� <br /> ', _ WAT[R HEATEF TION AUTHORIZED IS NOT COMMENCED WITHIN 1Y0 DAYS, OR IF <br /> URINAL CONSTiiUCTION OR WORK IS SUSPEND[O �lR q�ANOONED FOF A <br /> I OfiINKING FOUNTAIN PERIOD OF 120 DAVS AT ANV TIME AFiER WORK IS COMMENCE�. <br /> FLOOF-SINK OR DRAIN I HEREPV CERTIFV THAT I HAVE li[AD AVD EXAMINED THIS AP- <br /> VACVUM f3fiEnY.ERS PLICATION AND KNOW THE SAME TO BE TRCE AND CORFECT. ALL <br /> ROOF DRAINS-RAINL[ADERS PROVISIONS OF LAWS AND ORDINANCES GOVEqNING THIS TVPE <br /> OF WpqK WILL BE COMPLIE� WITH WH[THEfi SPECIFIED IIEREIN <br /> SINK ISERVICE-�AR, EiC.) OR NOT, TIiE GPANTING OF A PERMIT DOES NOT PR[SUME TO <br /> - GIVE AUTHOflITV TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW qEGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> _ SUBTOTAL _F <br /> PERMIT 5 <br /> TOTALFEE $ � <br /> x <br /> SIGNATVREOFCONTRACTOHORAUTH.AGENT DATE <br /> SIDEYAR�SCT6ACK STRE[TSET�ACK REARYARDSETBAC PLANCHECK NUMBEq PLANCHECKFEE <br /> FEE RECEIPT NO. <br /> USE ZOtJE LOT AflEA VACANTSITE <br /> ❑YES ❑NO FEES VALUATION FEE <br /> TVPE OF CONST. OCCVPANCV GROUP NO.OF OWELLING <br /> UN�TS � <br /> SIZE OF 6LDG. NO.OF STORIES MAX.OCC. LOAD BUILDING S �MV <br /> PIUMBING I <br /> FIREZONE BASEMENT FIfiESPNINKLERS <br /> flEOUIRED <br /> ❑YES ❑NO MECHANICAL � <br /> SPECIAL CONDITIONS: OTHER � <br /> I <br /> PENELTY SEC. 30JIe1 I <br /> TOTAL � <br /> PERMIT VALIDATION <br /> WHEN PROPEqLY VALIDATED IIN THIS SPACEI THIS IS YOUP PERMIT <br /> APVLIC/TIO�TED9Y: PlFNSCNECKEOBY: pi'PNOV(�iJ�fiI55l1Al1C[OY�. <br /> � A�4.� <br /> 3 <br />