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CONSTR JCTION <br /> PERMIT APPLICATQON <br /> COMBINATION • BUILDING • h;ECHANICAL • PLUMBING <br /> UWNIN MMLAUUIII:.:a ZIY 1•MUNt <br /> ! ,�/ / 1 q <br /> !� tl� Lv'='� // C /� I' ..�U�r"�`..'.�C ..2$-/ - Q �I/� <br /> ARCHITkCT UR DE51(iNkll � MpIL ADCNE55 YMONE LICENSF NU <br /> -�/` .c��.�.�/ylrTir/�'+,� f f. _�! 1�.�/�.��.6�,/� .2 -33 � '/ <br /> G Cl�LCONTRACTOR MAILAOO ESS � HQNE � r UCENpENU <br /> � �4•�/` i�. �„ f�diSc%�J r� .l,s�'_a.% �i nZ).�-:'�/ -�✓L�-LiL -AC 3%3<. c <br /> MECMANICALCONTRAGTOIi MAILADUfiE55 FHONE LI�ENSENO. � <br /> �'s��tr_-,v �.,..�,1,;1.. , � 7 Pd 3 1LF..✓ff- �.s-a- ')/.�" <br /> VWMUINGCONTRACTOR MAILA�DRE55 PHONE LICENSENO. - <br /> Y�L�__�� 3 :S .� .1 :� �r t . �, -- - <br /> iv.� <br /> t�n .,ov wonK i <br /> COMOINA710H <br /> ❑OVILDING �P�UMOING �MlCIIANI�AL <br /> ❑NCW ❑f�D�111pN ,�AlTE11HftUN HCP�iII I <br /> VAWATIUNUf WORK ' - -- <br /> f __�C OU�� � �OEMMiSN ❑fENCE ❑SIGN ❑•pVIMM�Nti PtIpL. I <br /> �kSCNIUC WURK ' — <br /> s .� L �- <br /> vqorostousE � OTHERPERMITS ORAPPROVAlS <br /> ����� ��/`�� j� RE ZONE � SPECIAL USE <br /> llGM D6iCl11PT10N OF YROPEPTY ISHOW UELOW UR P,TTnCH <br /> FOUN COPIlSI <br /> wr �-a� e�ocK�O or_P��L_s!=l.,cc,1. �VARIANCE � SN.ORLINE <br /> SE PA CHECK LIST REQUIRED <br /> L�' YES <br /> I� NO ' <br /> JOO ADDRE55 '� <br /> � I ` C_/,l-1 1 �'L'. +�I � '67ECHAN�CAL <br /> PLUMBING irve or cHeHur <br /> . ' I�.n5 �]FLEC. <br /> . � NO. _ _ TyP[OF EOUIPMENT. FEE <br /> MRCONO. VNITS-Il^. k0. --�"_-.--'-�-- <br /> NO. TVPE OF FI%TUPE OR ITEM <br /> __ . _ . ." _' ""'. ... .__--_.._ "- <br /> _____ . - FEE ntr nictnnTioN urv�rs -��iv �n. � <br /> —'-t—'- <br /> i�ni�i �u�is f -- ._.. ---.—._ ._ ..--- --...--�------1-- <br /> CIOIHF51YAyH6N ' � _ OOIICRS NP fA. � <br /> �voncen nin srsitMs 16T.V MEA. ~- —T� <br /> OISII VJnSMENti � __ _..._'.__' ___ .. ..._'"__" �___ <br /> UIIINY.RlCi VUUNI'AINg � '�'__._I_� <br /> f1.OqN DHAINS � �� . _ SYACF h WALL NEAIt:RS H.T.V. � <br /> K.ITCII6N SINY,S A OI51� — —"� ' UNIt uFMERS H.T.V 1 <br /> IIAlI51NK5 EVAPpNl�TIVECOOICNS�_—'� <br /> IIOOf IiHAINS IIAINLFM)[1,g -T— '-" CLoIRtSORvkt15 --j— <br /> SIIOIVhH OA1Hti yCNTILATION 1 AN T- <br /> !iEHVICE tiINKS -- ---�---� � � <br /> 6UMP5 tif.WA(iE PUMP A�NGF 11000 � <br /> U111NALti � Ml111AADUN4 VN�1 C.f.M. �� <br /> _" j""_"' L <br /> WNC11 ClOtil'15 —_J ' _".' .'._"_ "__'. _ -.. __' _�.......I... _. . � <br /> Wq1U1 Hf.AIF.115 � @LCf.INIC � 1 . . ..WnTER 1/EAtER � -'T�— <br /> WASM NASINti - �"'�'� fAC. BUIIT fINEPL/1C6 F CNIrdNEY j� <br /> LAUNUIiV Tf1AVti ._._ .__ . ' . "__ '. ___. _. . _ _ " _" <br /> OAS. SVSTEM NO ON OVTLI IS T <br /> � .' __._ . ' ' ._' .. _. ... l-- <br /> '— __ ..:VII tUML $ � <br /> i '__' _"___'__".. ._"'_"_-'__ '___"" <br /> -- �---- PEIIMII 5 � f�� <br /> ._._.__ ___ <br /> �_ _ �__ 1 _ _`__'"____'" _'__ .. _'_1nTAl f kF'_5 _ '-_-'1___ <br /> :,U� TOTAL ! ' ". __ _ ' <br /> __ PFIIMIT S 111Is PF11iA1T 11EC1`VLS NUt 1 �Nh VOIU 11 WUn✓. nN CU"1!1TnUG <br /> _ _]OTAL fEE-__ ---'-�. iION AUf11pq121t) IS NOf f'(Ih�AIINC[tl W�f111N 1]0 U,\v•:. pA IF <br /> CONSTIiVC11pN Of1 1YOfla C; ;U::1•1 NOfO OII Af1�NOON[U !(111 A <br /> wnir.nstr�vicesi�r AincSU�PIV $I)F Y��101IOI1]OOAYSN4NVfiMFAfiC111VOf�K �:1C(�'.�6�FNCfU <br /> �' " +' UA K NLAHY/�NU$lIf1�1GY.� I IIfNf.11v CEfITIFv f11AT I nl�V! IIf.AII nNDf<A1.4NID Ii�l: .\P <br /> �l1UTipN ANp KNOW TIIL !b\�IE 10IIL TIW(. ANU C(1011!fL M l <br /> PItl1VISIONS O� 1 �WS ANU OIIDINANCES RUVE�Y�NG 1���5 TYPE <br /> U:{L /IINL --� LUT AIILA ' -�'- n� WOIIK WILL BE COhIVIJFI] WI111 WrIFTREII ::Y1.CIF1lU bClIEIN� <br /> VACANf 51Tf UII NUT. THF GfIqNTINC Of 4 PF.nMIT [IOCS NOt PnE:ViAE �pl <br /> GIV11 �UTI�OftlTv t0 VIOIAf! ON CANChL fH[ 1'qpV�510N5 Of <br /> ❑VES NO . �NV q11�Ef1 514TE OR LOCl1l IAW nL(iVlllilN�iCOM:tInICTIUN <br /> TVPL UI CONST. UCl'UPANCY 4NUVM NU.Oi OW4LlING OII iHk PtqlDRMANCE Of CONSTIIVC�IDN <br /> UNI15 � <br /> ill - J.. ' � ) - <br /> S12L OF BLUG. NO.OF STOHILS MA%.OLC LOAO ' �` <br /> i " %-.z J <br /> X i tr�> , . ( <br /> 7. -- --- - --- � d��tintugCnr�Rncror`onnuni.`ncit�ri 'ririi�l�-- <br /> "i'i�T.-inNr'-•--- �ini:�rniNl iuiisru�NKi �.nr. <br /> NlOU111lU �lnNC111CKNUMOff1 VIANCH�IKILI <br /> ❑Y!5 QNO � <br /> ILC ❑ECEIPt Nn <br /> SPkCl/�ICONOR�ONS' _.,— ' �-�/ ^ '/L- '" . ' �D�/� <br /> FEES VAlUAT10N FFC <br /> '__ ' _"'___.'_' .._ '_ . " <br /> _". . T_" <br /> '.__` ._'—'__.' _�.___.—_ � <br /> '_.f"'. "_ .. .__.....__-- _'___— _.. L.'_ <br /> I —'— — " 11UIlO1NG f ---""� <br /> . 1 <br /> . _ ---- . ._-- —. . __......—� -- �- �---� -� r-�--- <br /> SEP� REVIEW COMPIETE � ❑YES ❑ NO —i �����MIIINIi -- _ i <br /> contact plonninq depl. Micr�nN�r.ni . i <br /> ---- � - <br /> DTIIUI � <br /> I <br /> �NIIC11111N1._ ---• ' �7 <br /> �Vuu�• +ier�oiaii.iun �wnovin u��ra�n vfN�LIY SEL d071H 1 <br /> '_ <br /> � . <br /> __.__.. .___.___ "' . L'_' <br /> . ._.. . ....' ' '.. . ....-.. .. <br /> TOTAL � � <br /> ..... . . . . . ._ _.__. ___ . � _.._�... <br />