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_ <br />�smi <br />OEPi. Of COM1RAUNIiY <br />u�vciorniuu <br />��`�t�>Y.�LS�-�E+9 <br />BUILDING <br />m � <br />ME�HANICAL <br />PLUMBING <br />�]DUILDING �PLUMB!NG �M1�ECHANICAL <br />❑NEW ❑AODITION ❑ALTERATION ❑REPAIR <br />VALUATION OF WORK — g, <br />$ (i/1�/�. ❑DEMOLISH ❑FENCE '[�SIGN ❑SWIMMING POOL <br />DESCRIDE WORK — <br />_ 'CO�'�na.IIt,`.ac,�. r <br />PROPOSED USE <br />�,��. M[CHANICAL <br />LCGAL OESCRIPTION OF PqOPERTY (£MOW DELOW OR A'fTACH TYPE OF FUE� �OIL ❑Gn5 ❑LPG. � <br />FOVR COPIES) <br />�oT o�ocK_o� _ NO. TYPEOFE�UIPMENT <br />Alq COND. UNITS-H.P. EA. g <br />REFRIGERATION UNITS-H.P. EA. <br />BOILERS-H.P. EA. <br />GAS FIFED A.C. UNITS-TONNAGE EA. <br />JO�ADDRESS -- <br />�ORCED AIR SVSTEMS-�.T.U. M EA. <br />yyy��` WALL HEAT[RS-B.T.U. M <br />=�'G; �'���.II •,Ci'_e UNITHEATERS-B.T.U. M <br />PLUMBING EVAPpRATI V E COOLERS <br />CLOTHESDRVEqS <br />��ENTILATION FAN <br />RANGEHOOD <br />N�• TYPE OF FIXTURE OR ITEM �cc AIR H.INDLING UNIT_ r c.. <br />U <br />E <br />�� <br />SPECIAL CONOITIONS: <br />STRE <br />�"�t <br />I <br />SUBTOTAL $ � � <br />PERMIT 5 <br />TOTALFEE 5 � <br />THIS PERMIT BECOMES NULL AND VOID IF WORK Oq CONSTRUC� <br />TION AUTHORI2[D IS NOT COMMENCED WITHIN 120 DAVS, OR IF <br />CONSTRUCTION OR WORY. IS SVSPENOEO Ofi ABANDONFU FOR A <br />PERIOD OF 120 DAYS AT ANV TIME AFTER WORK IS COMMENCED. <br />I HEREBY CERTIFY THAT I HAVE READ qND EXqMINE� THIS AP. <br />PIICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />{ PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE <br />OF WORK WILL BE COMPLIED WITIi WI'ETHER SPECIFIED HEREIN <br />OR NOT, TNE GRANTING OF A FEfiM1T DOES NOT PRESUME TO <br />GIVE AUTHORITV TO VIOLATE OR CANCEL TIiE PROVISIONS OF <br />ANY OTHER STl�TE OR LOCAL LAW qEGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />X ���+� <br />SIGNATUREOFCONTRACTORORAUTH.AGENT �ATE <br />EAR VqRDSETBACK P�qN CHECK NUMBER PLAN CHECK FEE <br />FEE RECEIPT NO. <br />4CANT SITE <br />❑VES ❑NO FEES VALUATION FEE <br />J.OF �WELLING <br />J�TS <br />I <br />4X.00Q LOAD BUILDING g��yy I <br />w Yj' � <br />PLUMBING � <br />RESPRINKLERS <br />QUIRED <br />❑YES ❑NO MECHAtJICAL � <br />I <br />OTHER � <br />I <br />PENELTV SEC.�03(al � <br />TOTAL z+ I..� <br />:� w <br />PERMIT VALIDATION <br />WHEN PROPERLV VALI�ATED (IN THIS SPACE) THIS IS YOUq PERMIT <br />