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- ��NS�'RUCT�Uf'� <br /> � �� PER��tIT ,4PPLI�ATEO�d � � <br /> COh1t31NATtON • BUILDING • MECHANICAL • PLUMF3ING <br /> OVlNtit w �ILAUUNtSS ZIY SI:/�TT/�;- YHUNt � <br /> �JOC. Ni/�� /�/c"'�f/L"� /1/L_ 1 LC- //G � , <br /> /� � � S`� / �/ 9j%77 3C �_ �� < / 2_ <br /> IAHCMITCCT U{/UC514NhH MAILAOOHE55 PNONh UCEKSE NU <br /> 1 <br /> IGENCRAI�CO) NTFlACTOFl MAILADDNESS PMONE � LICEN$f NU. <br /> /7 5 l'9-���� �'� 7-�- 3 'p � � <br /> MECIIANICAL WNTRACTUN MAIL AOORE55 PMONE LIC[NS:. NO. <br /> � /�.� ?��. r 5 /�����%H%,s . <br /> PLUMOING CONTqAC:ON MAIL A��Rl55 PMONE LI�ENSL- NO. <br /> . -i-'r���-c�ctr<y, ! Sc'Y?'N ���r��T ('LU•,;r�f�,,lC�- � -z , <br /> PEfiMli CLASS OP WORK • ` - 4 �' •+ ��� <br /> ❑COlAOINATION ' , _..�1,�pi'... <br /> r <br /> �DUILDING �PLUMOING �MECHANICAL • � � � ' <br /> � ❑NEW ❑ADOITION ❑nLTE11Af1UN - ❑NU'n�R � <br /> -'_"" "."_'_ _'. '_'_._...""'_ <br /> VALUATION OF WORK , <br /> . S ❑DEMOLIiH ❑FENCE ❑SIGN ❑::lYIM11MIN(i /•(IOt <br /> DESCHIOEW(,qK . - <br /> Paoroseouse O1HERpcRMITS ORAPPROVALS <br /> LLG4L UF:CRIV'JUN OF PflOPEflTY ISHOW 6CLOW OR ATTACM '� RE ZONE � SPECIA: USE . <br /> FOUiICOPIE51 � �r �(',VARIANCE {�} SHORLINE <br /> LOT_� BLOCK�OF����L'�G�'rnr G � +-f . _ <br /> � SEPA CHECK LIST REQUIRED <br /> I� YES <br /> � NO ' <br /> JUU ADDR6S5 ' <br /> _ E�G Ol ' Si C�/=�� ��I v/= , �MECHANICAL <br /> PLUMQING � � ' TYYE OF ENENGY � <br /> ❑�:n+ ❑EIF.C. ' <br /> . NO. TYFE OF EOUIPM1IENT FEE P� <br /> ' AIR CONO. UNITS-N.P: EA. .-..- �$ "-" � ' <br /> 7�0. TYPE Of- FIXTUR[ OR ITGhS FEE qEfRIGE�1nTipN UNifS HP. E/�. --- - _---T <br /> _I NAINTIIfSti � 5 ���� "'- OUIILRS H.P. EA. - " "- "'-`.�-�-' <br /> CLOiNFS W'tiHEH 'I,:�-�.•O .� .- . -_ .. . - --1-_ � ..- <br /> UIti1117d5HF:Hti • �) � FOl10ED AIR.SYST[A1$ D_T.U; �dEA. � ����__ <br /> _--4 �( ' <br /> DHIhY.IN�; f pUNI'AINS i ' � <br /> f 1009 f�11�IH5 � $PqC[ b WALI HEAT[RS .. f1.T.U. _ T-- <br /> '_'L__' <br /> KITO��FN tiINRS F. f]ISP. • VNiT NEATEHS ❑.T_U. I <br /> _ IIAIiSINti$ -� � [VAPONnTWECOOL[N5�— —r-�_ <br /> H �'1- nHNN$ RAIW LHl�UL-HS --�— CL0711LII DRYER$ "'"-_-___--- U(�- <br /> 5111 .\'hfi 11.1TH5 VCNTILATION FANT- <br /> SP11\'IC[ SINY.S ' -- �- <br /> SUtAPi �� tiEWAGE PUMP �7ANGE HO00 _ � (,�� <br /> � UHIN:•l5 � __ NH,IIANOIIkGUNIt .• -C.P.hI_. .._'_.J <br /> • ' _ '_—_'�.. . ." "'"" <br /> LVAIFN Cl0`�ETS � ��, • - _ � <br /> � \YATlfI HI:AlEl1S - ELECiItIC �r,l(• WATER HEATER"'�' ""' ' ' " '..•• _ _..-r— <br /> �L __________ _ �� .. . . .... ..��._. __.. _ .. . . ..�. .. �. �.���� <br /> "L \'JA.'iH OASINS - . �1 FAC. OUILT FIREPIACE R C/II�ANEY � <br /> _"_-_ � _" __. . _.. ._-_. -_..._. .. .._._'__...._ _... _""'T__ <br /> LAUf�[IIIY TItAYti , _ GAS. S�STEA1: NO OP DUTLf.15 <br /> � . - --- �---'- ... .auh iorni. s ���U <br /> . � --_..__.-a[nMir� 5 -�--� <br /> �� ' _ �.��_._ji=:� <br /> SU41'OTAL .. _"—_'_--'— �_'TOTn4 FtF 5 ` _�,�X� <br /> �� 111I5 PEIIh11T U[C00./E5 NUI l. AND VQIU 1{ 1YU{IY, UH QUNSTRt)C <br /> _PERAt1T 5 �f� ilqN AUnlpf�tZEO IS NOT COb141lNC[I) 1YIi111N 170 Unv!�. Oit ir- <br /> TOTAL FEF C COMSTRVCf10N Ofi WOIIK I!: $U:e9'NO[O O11 Af1ANDPNCO FOit .� <br /> YATFR Sf.HVIC[ SIZ[ � �tDG.SUPPLY : IT.E � I �� ' P�RIOO OF 170 DAYS Ai l�NY flht{� A1 TEf11YOfIK I!:Cahtl.lENCEb <br /> +��E�'�n�: +� f.n T 7 � 'c�unCK NLnNrnHUSLTtincic� � ��[Rtuv CERTIFv.nlnt I ��AVE NCAU AAn E%AldINID T111, n= <br /> PUCATION ANU I:NOW 7H[ SAA1C TO IIL TRUE AN[1 CUIiRf'CL \LL <br /> �]!r-� �r" i' ��1�1�'� PIlOVI51UN$ Of LANS ANO OfIOIN/�NCES GUV[PNING TIUS TVPE', <br /> �� � � OF 1VOItK \YILI �[ COh1YUCC� WItU WNtT11ER SP[GFIEU NE(iCIW <br /> US! 'l.UNL LUl ARLA�[� VACANTSITh OH NOT, �HL GRAN9ING Qf A PEHM111S��'iDES N07 PNESVME TOI <br /> I - qJ / GIVE AUTI��`ORITY TO VIOLA�E DjL ChNChI TIIE 1'qUVISION$ cr <br /> � f ZIIU� /' QYES ❑NO , AN�' O7HF:�T�OR LOCA 7�\Y HCC.UI.ATINy CONtiTf1UCTlOhI <br /> fYPE OF CONST. OCCUYqNCY C;RUUY NO.OF UWhLUNG OR TME PCfIF MANCE D ONSTRVCTION. <br /> UNITS � <br /> � —�� T � � ,,� , i=. �����cy <br /> 5121 OF OLOG. NO.OF STOHIES MAX.000. LOAO � .' �\�- -"�� � p�,'` _L'/J <br /> �� i <br /> • Z ' � X .G._._._.: .�:_ . <br /> ��IIILZONt' IIA:7kMLNf . IINl51'f11NKLL�15 • �S'NATUHEOf ONT 11C70HO�lAUT16f�GENT pATF <br /> `� -_ Rl:OUiHCU 'LAN GHLGK NUI.IUL1� 1'LAN CII�I;K Fb! <br /> ❑Y[5 <br /> F'CL' ��ECE�PT N(+. <br /> iPlC1A�CONDIT10N5: L !_' �') �� <br /> ��7 ;1�� � �f�• -� � a ?� / � <br /> �� FEES VALUAT�ON FF.E � <br /> � - -----r— <br /> ��__.__ i <br /> . _._..--- --I — ..._ <br /> ._..�__._. I sui�owc s- = :,,_:��,`�� _ 1+�=; j..c_, <br /> �• �=---__ .r_— <br /> � PLUMIUNq /' � <br /> SEPA REV(EW COMPLET[ � ❑YES ❑ NO LI �.0 <br /> cenlact plonninq dOP�. MLCIIANICAI—_W•_ , /J iQ(� <br /> _ . _ . �._..... <br /> ' on�cn ' � . <br /> i <br /> �— <br /> �`1Iq11yHACNfIIYY�� _ IUxSWll4\UYY:-_'_ .{MOpV1U ol nmwnwcl�v � PpNAL7Y SEC.]091d 1 <br /> ' � . � ___� �_ _' _"'".__'• _. __......L__. <br /> � l-- . C• TO7AL j <br /> r <br /> t <br /> . . . .. : � <br />