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. ���;��.�,. <br />h; J�r <br />�o:;F��<;;:? <br />,.,Y�.;r�Lti:�e: f <br />•}A �i: <br />t�.`. <br />i:'. • <br />- �����TRUC�'10(� <br />�'EI�d+,/il � AI'PLlC,�iIC��! <br />COMBINATION • dUtLDlh'G • MECHANICAL � PLUMBI�IG <br />'txM1� � CLASSOF WO� <br />❑COMDINATION <br />❑OUILDING []GWMBWG �MECHANICAL <br />�—"'"'"'.�_ . ❑NEW <br />LOT � BLOCK�O <br />1✓ i (' � 7, �7 .� �e <br />E� <br />PLUMBING <br />s�A-�/ ���p rs�Ah � - <br />�{94DC�IiIUN ❑ALTEfinflqN ❑NCI'n111 <br />❑DEMOLISM ❑GEf�CE ❑SIGN ❑SWIMMING PpOL <br />fTACH <br />>THE'2 PER1�11T5 OR APPROVAlS <br />j� RE ZONE �j SPECIAL USE <br />�L�'ARIANCE � SF'ORLINE <br />5 E PA CHECK LIST REQUIRED <br />.� YES � � <br />L� NO ' <br />MECHANICAL <br />TYYE OF ENERGY <br />p .ns <br />E Lf.C, <br />— AIP CONO. UNITS-H.P. E0. .. ._..---?S 1 <br />R6:RIGERATION'UN�fS NY EA. •---T <br />_ �OILERS 11P EA.-'-�"—� '— � --1— <br />FORCEO Alii SVSTEMS �.T.U. MEA. �—T�_ <br />_ _"_ '�"' � 1 <br />SPACE & YlALL HEATERS �� fl.T.V. _—r— <br />� <br />UNIT 11EATEPi P.T.V. ' i <br />EVAPDHATIVE COOIEH$ —T_ <br />' VENTIIATION FAN � <br />NANGEMOOD <br />AIFI HANDLIN(: VNIT � C.�.M. <br />.. WATEH HEnTEH"" —'' " _"" ' ' — <br />FAC. �VILT FIPEPIACE f4 CHIMNE�' <br />GAS. SYSTEM: NO OP OU�LF.15 <br />" '_ _ ' ' '_ ... _. . _ . _ . ..,_... _ . ._' ' <br />--- --- suo �orn�—s •--.-- <br />SUD TOTAL � _ TOTAL FEE 5 1 ' <br />PER611T S 7���5 VF.f�M1T U[CO�dES NUI L AND VOIU tl WORY. DR CONSTRUC <br />TION AVTIIORIZED IS NOT QpMMINC[n WiT111N 7?0 UA�S.OR If <br />TOTAL FEE S � CUNSTfiIICIION On WOHK 1•: SU::�'CNDLO OR AfInNDONEO FOA A <br />YATER SF.RVICE SIZE pLDG. SUPPLY SIZE ' P�niOo oF i7o �nv5 nT �tiv nM1+t AFTEH WOIu; i`:COAtaENCE6. <br />g� �l{i ci 3 UACK RtAHYAH05ETOACR� I UCR611Y CERTIFY TIIAi 1 IIAVE HEAU AND E`CA�r�NFD TIUS A�� <br />� PUCnTION AND KNOW T/IE S1ntE TO Ul TNVE nNP CUHRi-Gi, nLl <br />PfiQV1.lONS OF LAWS ANO qf1DINANCES GOVERNiNG �w: T\'PE <br />. OF vlONK WILL DE COMPUF.D WIT11 %HEiMER::vECIFIEU NEREIv <br />US! T.UNt - lUT AHIA VACANT SIT! - ON NOT. T11E GR�1N71NG O� A PER�dIT C7E5 NOT �HE5Uh1f TO <br />. GIVC qUT110R1TY Tp VIOl4fE OR C/�NClL TI�E �'�l(IVISIpNS OF <br />� ' ❑YES ❑NO , ANY OiHEf1 STATE Oq LOCAL LAY/ N�GULATWIi C.OM:i11UCTiON <br />TrVE OF CONST. OCCUPANCY GROUV NO.OF DWtLLING 0f1 TME PEHFOHMANCE Oi CONSTPUC710N <br />.....�.. 1 e <br />❑Y[ : ❑NO <br />SPl:CIAL CONOITIONS: <br />— � . . I OUIL�ING <br />SEPA REVIEW COMPLETE � ❑YES I] NO '�'<<�""mru� <br />confacf p�onninq dOPI. MECIIANICAI <br />' on�en <br />Nl`1 _CAl1UNACN�I�:Y1�_ YUN9{;NIINYYY: AMIIOVIUTI.YY PENALTY— <br />' �Z. C <br />TOTAL <br />1t <br />iG[ <br />.-.._ I.... .VAWATION <br />ILC'. <br />�I�Et - 7�. -. <br />�� <br />FF.E <br />s �, y �r9_ .�ai o� <br />-- — •r— <br />i <br />�. <br />. � <br />_. _ �.�... <br />$EC_.�D� (��....._...I____._.. <br />d <br />� <br />.-�T <br />�_� <br />