Laserfiche WebLink
-- __ _---- --�.... 1 <br /> � <br /> d_�.,� .��� <br /> �NEw-Wa�n �+PPLICATIOf�! FOYO cvcrctl <br /> ��r�F �OfNSTRUCYION � <br /> eV��'�tt PElZ1�91T <br /> TO BE COMPLETED IN BLACK INK— PLEASE PRINT <br /> BUILDING DEPT. <br /> " 259•8745 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMOING � SIGN <br /> � JWNFR MML��ORESS _� — �nv l�l+ In�oN! <br /> TH�v�7zaf rc� 5�3 � c �V nfiwkFPN ctini r_�,7 ���° �; z�� <br /> ♦NGHi�ECTON�E510NEN MML�)Df1E59 f,ilv I�� PnONE <br /> � <br /> �ENER�I COhTRACTGR Mn�L�DDNE55 Crt� 2iP �'��ONF LiCEMSE• <br /> 13E�n�Y.�. ,vr-a„� •:�x-.�.� 2i0z- � � rTa�. GYNN wA �'lSo3� 77F Sc3s RFRRt',✓2�i7LYJ <br /> MECH�NICALGONTMC!Oq � s1A1L��ORE55 Li*� I�P �'�IOHF L�CENSE• �r�. <br /> �WMBINQGONTR�CTOR M�IL�OORE55 Ci�r I�P PNON- IiLENSE• <br /> CL�990i WOflN <br /> NEW ❑ AOD�T�ON ❑ ALTERATON ❑ REPAIq ❑ DEMOUTION ❑ WOODSTOVE/FRPL.INSERT ❑ 9� I JING AELOCATION <br /> ALWIiON OI WO�K�COSTOF MAIERIALS VLUS LAOCf11 <br /> �`/� 90 `� - -- - <br /> — <br /> ^es �ioewoaK � <br /> TNS7--r1-LL U> s 3d � X� G 7�7��r,i'r/� ;[Ztv�t�_5.7sn�,- - <br /> �s[o•9unoi�+c <br /> I HEREBY CERi1F'I THAT I HAVc RE��D �ND EY./M�IJED THIS AP- <br /> Cs fv�+ f3`79�C S�N pUGATIONANDKNOWTHESA�dElOGEi��I�EAI�CCORRECT.ALL <br /> ,EuALDE9CFiVTIONOFPPOPERiYISNOWNBELOWONAITACHFOVRCOPIES PROV�SiONSUF:AWSANDOFDINNNCcSGOVERP:INGTHISTYPE <br /> OF'rYORK WI!L OE COMaLETED WITH WHEiHEfl SFEG!FIED HERE- <br /> . �or_e�oc• or — IN GN NOT.THE GRANTING OF A PFRMIT DOES NOT PHESUCdE TO <br /> GIVF AUTHGHITI' TO VIOLATE OR CANC_L THE PROVISIONS OF� <br /> ANY OTHEF STA:E OF LOCAL L�W HEGUTATING CON3TRL'CTION <br /> OR THE PhRFv%iMANCE OF CGNSiRUCTION. <br /> SIGNATURE OF L�`;��RpCTOR OR AUTHOR12ED AGENi OALE <br /> ls 10�0 �"��/L6��'N ��"�`� X �� �� <br /> PqOJEGTADDNE55 APPLIW f5 YBUSINESSLILFNSENO <br /> PIUMBING _ MECHANICAL _ ______ _ <br /> NO. T'PE OF FI%TURE _FEE _ NO. __ TYPE OF EOUIPMENT_ _ _ _ ___FEE <br /> WATERCLOSET�TOILED A��COND UNitS-1�P FA __ _ __ _ _ _ <br /> BATHTUB REi"RI(iERATIpN IINITS_H P EA ______ __ __ <br /> LAVATORYIWASHBASIN) BCIIERS_NN Cn . ___ _ ____ <br /> SHOWER GAS FIRED AC. UNITS=TONNAGE EA _ _ _,_ <br /> NITGHEN SINKB DISP. FORC[D AIP SYSTE615=6 T U TA EA_ _ _ <br /> DISHWASHGR WALL NEATEi7S-8 T.U_M <br /> UUNORYTRAY UNITMEATERS-B.T.U. M __ _ <br /> CLOTHES WASHER £VAPORATNE COULERS ___,_ <br /> WATERHEATER CLOTHESDRYERS ________, _ <br /> URINAL VEN1ILAilON FAN _________ <br /> ORINKING FOUNTAIN RANGE 11000 _________ ___ <br /> FLOOR DFAIN AIF Hf.�lDUNG UNIT- C�_Id _ <br /> VACUUM BREANERS STOVE _ _.___ . <br /> ROOF ORAINS-RAWLEADERS METnL FIPEPLACE 8 CNIMNEr _ <br /> SINK SERVICE-BA ETC. WOODSTOVE/FIPEPLACE INSE7T _ <br /> SUB TOTAL ---- - '.�� � _ SUB TOTAL __ .. S -- <br /> VEHMIT i _ ____ _ . __ ___-' PENMIT__ _.._ S __ ..— — <br /> TOTALfEE 3 , _. __ _ _ _. . _ ?O7nL FEE _ S _ __ _ __ _ <br /> THIS PORTION TO BE CQMPLETED BY BlJILDING DEPT. PERSONNEL <br /> �qOYISETp�GK REARSETBACN Si0E5l�U�CK vUriC���-•.4uMi�U� --- ----�--Ivnq�.iqLrtlf �-'�- <br /> rry. mr,EiriNO <br /> USElONE �OTME� y��,W�&fE � � , <br /> •EES ��tU�iIOM FEE <br /> ']vE4 C�NO _____—_.—. _."__ .___" ___—___ ' <br /> IVPEOF�ONST OCCUP�NCYGAOUP NOOfOWELLINGUN115 <br /> _ __ ._—_ t <br /> �UIID�NG S � <br /> SIZE O�Bi[�i NO OF SIOPoES M�c OCC LOAD --- — <br /> PLU�ApING <br /> __ _— "_ __ � <br /> MECH4NiG♦ � <br /> FIRE SPPINKLERS REOUIRED ❑ VES ❑ NO - <br /> on�tn <br /> - - - � - - - ------� --- -- — ' <br /> LPEflALIY _ __ __-__. _ ___— ___"_ _ 4 <br /> �CVLIC�l10N�CC BY PLANS CNECKED OY •PCR iGN�SSUAIICE 13� ---- -- - <br /> � \ iOTAL __ ___.-_ . _I '-'___.' f <br /> ._—_.__'_ '-.. ._"" _ � <br /> � � � / / , <br /> � �� <br /> �ji�/�o <br /> ,._ ,� . _ . � <br />