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APPLIC/ATIC�I FOR CONS�'RUCT'r1N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT r HEATING SYSTEM: �GAS ❑ELECTRIC ❑ <br /> 259-8810 <br /> ❑ DEMOLITION i I COMBINATION ❑ BUILDING f�MECHANICAL I� PLUMBING ❑ SIGN <br /> OWNE� IM li�Lll �-C�� MAILIIYJ�Sr_.)It/�� LiVl�l., ll �UZO� /�II�IVI-� �%�.r�Y�) [�-J7�l � <br /> TiN T � 4AILADORESS CITV ZIP PNONE <br /> �A-Yt �Q�LL,�_ Z61� C„I�v �Y�r�� �I�C �v 1 20(� 252 GZ5'v <br /> ARCMITECTORDESIGNEfl �MpILpDD�ESS CITY IIP PHONE <br /> � r� Y � lt.�� I�x�s 5154- (� 9 �'zZ 3 ��,4, 7.�� 3i� / <br /> GENE CO RRCiOR MAIL AOURE55 CiTV 21P PHONE SiATE UGENSE� <br /> J�M�^ICA T qp�q MAI��E�p� CItY 21P PNONE ST�TELKENSE• <br /> 1�i t l. ��(rV � <br /> PIUMBINGCONiRnCT MAILRDDRESS CI7V ZIP PHONE STATELICENSE� <br /> CONTH�CT PRICE Of WOHN <br /> �ESCRIBE WORN AND SOUFPE FppTAGE INVOLVED CONTRCT PERSON ANO PHONE NO. <br /> 'in an f� en ' �Q.►'L�(�Ik�nsar 252-Uzyv <br /> I HEREBY CERTIFY THAT i HAVE READ AND EXAMINED THIS <br /> PROPOSE�USE OF BUIIUING APPLICATION AND KNOW THE SAME TO BE TFUE AND CORRECT.AL� <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> IEGALDESCRIPTIONOFPROPERTY�SHOWNBELOWORATfACNTWOCOPiES� WORK WILL BE COMPLETED WITH N'HFTHER 3PECIFIEO HEREIN OR <br /> �or e�.ocrc oF NOT. THE GRANT;NG OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER ST�.TE OR LOCAL LAW RECaULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PFOPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PAPCEL T�%ID.NUMBER CONTRACTORS LAW 18.27 HCW AND 296.2C0 WFC. <br /> CONSTRUCTIONIOANLENDER.A0DRE55,TELEPHONENUMBEN ei � J <br /> '�/VVV-�� 5 26 3 <br /> PROJECT ADDRESS rv o�iE <br /> CiivBUS0.T55liCCNSI NJ <br /> PLUMBING MECHANICAI <br /> NO. TYPE OF FI1(TURE OR REM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) � ArC—A/HNDLG UNITS--H.P. <br /> BATHTUB ; FORCED AIR SYSTEMS-6.T.U. M E.A. <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M ; <br /> SHOWER CLOTHES DRVERS T— <br /> KITCHEN SINK B DISP � VENTILATION FAN <br /> DISHWASHER RANGE HOOD , <br /> LAUNDRVTRAY ' WATER HEATER <br /> CLOTHES WASHER � WOOD STOVE ; <br /> URINAL METAL FiREPLACE(WOOD BURNING) � <br /> ORINKING FOUNTAIN FIREPLACE INSERT ' <br /> � <br /> FLOOR DRAIN � HEAT PUMP , <br /> BACKFLOW PREVENTERS ; GAS PIPIN3 � <br /> ROOf DRAINS—RAINLEADERS � EXHAUST FAN <br /> � SINK(SERVICE—BAF.ETC.) ; <br /> � ' <br /> � <br /> � � <br /> � � <br /> � <br /> SUB TOTAL $ � SUB TOTAL $ �' ��j�� <br /> PERMIT $ � vt� PERMIT $ ' <br /> TOTAL PEE $ a 't� TOTAL FEE $ r� �U <br /> FOR OFFICE USE ON�Y: + �'�_ <br /> FRONT SETHALK REAR SET6RCN SIDE SET a P�AN CNEGK NUMDCR FEE REGEIPT NO. <br /> /�O 73 <br /> vse zorae LOT AREA VAGANi SRE FEES VALUATION FEE <br /> ❑ YES ❑ NO BUILDING � <br /> ttPCOFCONSt. NOAPSTOPIES acurexa NOaWmuxtuxrtS <br /> 4800� PLUMBMG � <br /> i <br /> SIIEOFBLDQ FIRESPRINKIERSREO'0 BASEMENT MECHANICAL � <br /> ❑ YES ❑ NO -- <br /> OCGJPANCYLO�D �IREALFFMRf.OD HEIGHTLIMITATION ADDITIONALPLANCHECK � <br /> OTHER � <br /> FEASON -T <br /> S7AT[BUILDING SUFCNAfiGE � <br /> INTAKEBV PLANSAPfROVE�BV CIiYOFEVEREIT PUBLICWORKS <br /> �ocn�sa�es <br /> on.e TA1f CODE IS 3105 TOTAL ; <br />