Laserfiche WebLink
, � <br /> �.. .�s <br /> ,�„E .,o,,,� �PPLICATION Fl. � ���,e„ <br /> ��TM°F CatdSTRUCTION � <br /> �v�rett PE RM IT <br /> TO BE COMPLETED IN BLACK INK— PLEASE PRINT <br /> BU�L�ING DEPT. �.,� <br /> 25��874° � Cc�MBINATION Ly' BUILDIt:G ❑ MECHANICAL ❑ PLUMBING I� SIGN <br /> ov,��ee—}-��� Mnaeoor+Ess ,�� c�rv zir a�ior+e <br /> � 'L3C.__�S'LJ'tl`� v�� /C�� /�l� ��r_��(/Ur �/fr�c�0.����7� -- <br /> OqpufFCTDRUES�GNER MAILRD�RE55 Cltt 21P PRONC <br /> �1����.L�� ��. <br /> GEI�EIIALLONIHACTCn MAILRODflr55 Cltt ZIP PMONE LICIi115E� <br /> MEGMANIGALGONiR�CTOq MRII �npRE55 GITY ZIP PIIO1lE LiCENSE� <br /> PLUMBINGCCNiN�GfOR M�ILpDORESi Ci�Y 21P PIIONE LiC[N$[• <br /> C1B55 Oi WOqN <br /> ❑ NEW ❑ ADDITION ALiERATION ❑ REPl�IR ❑ DEMOLITION ❑ WOODST04E/FRPL.INSERT ❑ BUILDING RELOCATION <br /> VRLUA��ON OF WORK�GOSi OF MATERIALS PWS L/BORI <br /> O <br /> �.�000. � <br /> oescame wonK <br /> �qr fjf�dN (.1/i1�/ <br /> ue�e oF euaoiHc <br /> �� ' , r �/ � fG/ / I HEREB'Y CEaTIFY THAT 1 HAV� READ AND EXAMItJED THIS AP• <br /> PLICA7IUNAND KNOW THE SAME TO BETRUE AND CORRECT.ALL <br /> L[GBLOESCNIPiIONOFPHOPENTY�SNOWNBELOWORATTr1CNFOURGOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNIMGTHISTYPE <br /> OF WORK WILL BE COMPLETED WITH WHETHER�PECIFIED I1ERE- <br /> lJT_BLOCIL—OF IN OR NOT.THE GRANTING OF A PERMITDOES NOT PflESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS O� <br /> ANY OTHER STATE OR LOCAL LAW REGtII ATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIGNAipRE OFCONTRACTOfl OF 11THORi2ED AGEIlT D�IE <br /> X /,�� l ,:�,,,,_ ._ 7— i o — �� <br /> PROJEGT AODRE55 A�PLI6AN I'$CI�Y 9USINOS$UCENSE N0� <br /> SZ�' � Uf .rC �:� / ` <br /> PLUMBING MECHANICAL <br /> NJ. TYPEOFFIXTUHE FEE NO. TYPEtiF:OUiPMENT FEE <br /> WATER CLOSET�TOILEn AIR COND. UNITS—N P.EA. _� <br /> BATHTUB REFRIGERATION UNITS—H.P.EA. <br /> LAVATORY�WASH BASIN) BOILERS—I�I.P.EA. <br /> SHOWER GAS FIRED AC.UP::75—TONNAGC-EA <br /> NITCHEN SINN 8 DISP. FORCED AIR SYSTEMS—B.i.U. M EA. <br /> DISHWASHER WALL IIEATERS—B.T.U.. h1 <br /> LAUIJDRYTRAY UNITHEATEFS—B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WATEF HEATER CLOTHES OfiVEHS <br /> URINAL VENTILATION FAN ' <br /> DRINKING FOUNTAIN RANG[lIOOD <br /> FLOOfl DRAIN AIR HANDLING UNIT— C F.M. _ <br /> VACUUM BHEAKERS STOVE <br /> flOOF DRAINS—RAINLEADERS �+�ETAL FIREPLACE 8 CIilA1NEY <br /> SINK SERVICE—BAR.ETC. WOODSTOVE/FIREPLACE INSERT <br /> SUBTOTAL SUBTOTAI S <br /> PERMIT S �ERMIT S <br /> TOTALFEE S TOTALFEE 5 <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> FRONt SELBRCK REFR SEiBPCK SIDE SGTBACK �IFN GHECK NUM6EH PlAf1 CI�EGK f'fl <br /> �XISTCi — - — --�• FEe �3 nE�urrr�Q <br /> USEZONE LOTRPE� �� �'J� �}��- d �� � <br /> VPCANf51iE � FEES VR�UATION FEE <br /> �.Z '— ❑Y[5 )WO _—__ __.._"____"_____ <br /> iYPEOFCONST. OCCUPANCYGROUP NOAF�WELLINGUNIiS <br /> ���/�'\' �'-Z v BUILDING 5 <br /> SIZE OF BLDG. NO.OF SIORIES MAK OCG L04� <br /> I�j�(J I� NIf�Z ��� PLUh781NG <br /> MECHANICAL <br /> FIRE SPRINKLFRS RE�UIRED YES ❑ NO �Y�S( ��) � <br /> OTHER <br /> PENRLTV <br /> APPLICATIONqCG.UY PLANSGHECKE�BV APPR.FONISSUANL[DV — <br /> TOTAL <br /> �G <br /> �� <br /> � � <br />