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. <br /> - CONSTRUCTION <br /> PERMIT APPLICATION � �3�c =/�� <br /> i <br /> COMBINATION • BUILDING • MECHANtCAL • PLUMBING ' <br /> DWN MAIIAUUNkSS 11Y MMUNh <br /> �<:��1 --,ti��,��r �����4 /-�',dAy h°�:- � 1 �� - �.3�'7 <br /> ARCHI7ECT UH OF.51(iNEfl / MA�LqOUHESS iHONE - <br /> UCENSk N—�- <br /> GENCRA��ONTRqCTOR MAILADOHE555(.qJfLE PNONE <br /> � LICENtiE NV. <br /> �N,vari�T,v�, ,�lva urs� � vvf/�/I" /�sts _,6.?���i� � ,3- -.vo .v <br /> �^ }^nrv�i,n��VrvinnGT�(lH MAILAO RE55 � '1 � �� <br /> � IN�1NE IICENSE NO. <br /> ►LUMBiNGCONTRA�TOH MAILAODRESS /MONE <br /> , LICENSE NU. � <br /> VERMIT CLASSOF W0f1K -�- <br /> ❑COMBINATION • <br /> ❑OUIlO1NG (]V�UMBINC �MtCHANICAL <br /> ❑NEW ❑ADDITIUN ❑n1.TE11A�lUN HCPn�II <br /> VALUATiON OF WORK -`—. ..__._.. ,_._..___ <br /> � <br /> S L OOO C ❑DEMOLISM ❑FENCE ❑SIGN ❑':\VIMMiN(i 1•U04 <br /> OESCjiIUE WONK , � <br /> � il.N /f /�•n� <br /> •noroseo vse OTHER PERMITS OR ApPROVAlS <br /> IIGAL UkSCA1PTIpN OF PnOPkRTY ISMOW BELOW OR ATTACM � RE ZON E $� SPECIAL USE � <br /> FOUP COPIl51 � <br /> ior_Ze�ocKZos�' . �VARIANCE .t� SF!ORLINE <br /> p'�K �� - � I c T7 SEPA CHECK LISi REQUIRED <br /> —•�� L� Y E S <br /> � r�'S r.�.+ S< FT =! N o . • <br /> 10!ADDHE55 L <br /> �� `�� �- v/ �MECHANICAL <br /> PLUMBING TYPE OF CNEHCY ❑('^+ <br /> � ❑ELEC. <br /> _ • NO. T/GE Of EOUIPh1ENT� ---T FEE <br /> AIRCOND.IJNITS-N.� EA. . ��ts ..-'-- � <br /> NO. TYPEOFFI%TUFEORITEM1I fEF, qkFR1(:ERaTInyUNIfS �1V. EA —��� <br /> HAIH Tll�g S �� ' " - ._ . � <br /> f:IOTHES YJA$HEH � _ DOI�ER H.P EA. ��� � <br /> UISIT YlASMEItS � FpRCED AIF SVSTEMJ fl.T.U. ME� i � <br /> Uf11NKI�1G FpVYTAIN$ � � <br /> FI OON VIIAIf:S � SFA(:i . WALI NEATERS .. fl.T.V. � T <br /> r <br /> Klli NhN tiiNK5 Bi OI$1'. � U'+Ir ��EnTEFlS q.T.V. —� I <br /> IIAfI51NK5 i EVnoOHAT�VECOOLEHS _�T— <br /> ROQF DRAINS RNN LEAUERS ��---'--"..'----- � <br /> � CLUT11E5OR`/EPS � � <br /> SHpµ•EN (tATNy � - <br /> SEtiV�(,E SINKS VENTI�nTION �AN 'r T <br /> ' RANGENpOD i ' <br /> SUMYS - SELYAfiE PUM17P 1 <br /> U(11NALS AIH 11f�NDLINf.VNIT • C.f.M. �-- <br /> � <br /> WAtEN CLOS[TS _i _"'.'___'-... ...' ."' -_ �.. ' <br /> � _ .."_' .__.. . � . . . _ _...... �_�� <br /> WATEn NEATEIIS � ELECTRIC � M/47ER HEATER <br /> WASH BASINS • � FAC. 6UIlT FIREPLGCE h CNIIANEY -�� <br /> IAUNDRV TIIAYS � f.4$ SvSTEM NO OP OUTU�.i$-'...��'"T�� <br /> � '-'-" ... ••.^.UO TqfAL 5 , �� <br /> . � 1 '�_' __"vEnM�T ._�.__�"__i__.�_ <br /> SUO TOTA� � � Tntnl f FE_5� _ � <br /> � <br /> PEflMIT 5 11115 VEfir.11T.UECOM1IE$ NUI l. flND Vp1U �1 WUIIK IlH CU`15TRlJC <br /> TOTAL FEE -� TION AUf110RIZE0 I$ k0� f.(1`dMIN�[p WiT1UN 1?0 UAv!, (Iq �F <br /> CUNSTIlUCf10N OR WOIIR I:: SU::�`FNOED OIl ApANDO.`:EO �Oi: A <br /> WATER `FRViCE SIIF. BIDG SUPPLV S17E vEniOo OF i�0 Onrs ni nNv fiMt. AFTff11YOf1K �':CP•.�!!ENCEU. <br /> �J St n .. JACn NhnHYANU]EIB4CC, I IICREIiv CEIiTIFY TIIA7 I I�AVC fllAU AhD CYnl.�IN[O �I115 Ai <br /> PLICATIpA l�ND KNOW i14 5.1ME TO Iil TNUE AN!) COI:�IfCL AlL <br /> V(�OVIS�ONS OF �A1Y5 I�NU OIIDINANCES GUVER.'+iNG T11i5TYPE� <br /> US( ZUNk ~ LUT AHLA - OF WOIIX 191{,L BE CO'dPLIEp YJIf11 YfHETHE{I $PECIFI!p HEN:INI <br /> VACANf$ITF ON NOT, T�iF GpAN71N(: OF A PENMIT ppES NOT PRESVME TO� <br /> � ❑YE$ ❑NO GIVE Al)TUAl11iY f0 VIOl4fE pN CANCLL T�IE ✓AUVi5iON5 OF <br /> , ANv pTHER STATE Ofl IOCA� I.AY! NC(iULATINi: CONtiT11V[T�pN <br /> TYVE UF CONST. UCCVYANCY GROVY NU.OI OWELUNG �� TME PERFpqMANCE O� CONSiHVC710N. <br /> UN1T5 a <br /> i�ZC OF OLOG. NO.OF S70RIE5 MA%,OCC. LOnO / � <br /> � � x' ' � , . /1is � <br /> Illlk'LONk IIA7;lMLNI ' /111�!�IYUNKIl11.5 �TVNE CON RA�TOf10NAUT11.AGkNT ATE <br /> � RfOUiHlU lAN LML NUMUtII VIANCRtCK 1 LL <br /> � ❑rE5 ❑r+0 ItC �tECE�rrHt� <br /> SokC1Al.CONOITIONS: <br /> ' .. ..�,.._�_�". . . . . _ . ... . . . <br /> FEES VALUATION FETE�. <br /> _ __ -T- 1 <br /> �^ uui�oiNc s ' � <br /> —_ I --_.__ _. � <br /> _..r_�. <br /> SEPA REVIEW COMPLETE � ❑YE$ ❑ NO • •�"""n'N'i i <br /> ..._ ..._..--•• �. <br /> eonfacl p�a��inq dept, M�c�i�Hit�i • j <br /> - . _ . �� ... <br /> � OTII[R ' <br /> I <br /> wut�i�cvn�urnun /LAM)CNIl41U�Y ,wepv�o u�l+r vFNALTY SEC.707b1 1 <br /> . . � . <br /> � -_ _ _ _"""'"__ ' "_.'.__L_. <br /> _.""' __'_� __�_.__ ... iOTAL I 7 <br /> 1 <br /> fr <br /> "Ci <br />