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� " �►� r� <br /> COM6lNATION • BUILDING • MECHANICAL � PLUMBING <br /> MAILAUUHt55• ZIY YNUNE <br /> J�YNLiI -- • <br /> /3 i s- !',N n• . ru .v 3s•'r — 3 7 0 `/ <br /> !.�� �����f /� JC �� ' 2 af � N pHONE UCENStNV. ' <br /> aRClIITECTUIIOESIGNhf{ MAILAUOf1E55 <br /> Ph10NE • LICENtiE NU. , <br /> "ENEHAICONTRACTUR MAILADDHE55 ' > <br /> / JI'� ?J L=ve +<:/� iS J�127j' � 7.7•—n/-�J !—rv —R�.,.�t 2 )G <br /> `� �. •�� �Y c' �--' / 'y✓ , ./y"""7 '} PIIONE ' LICENSE NO.. • <br /> NECMANICM1LCONTR�ICTUR • MAIIAODRE55 . <br /> MAILAOOflE55 PHON LICENCENO. <br /> Y�UMHING CONT,RALTOR . . „ . <br /> VERMIT CLASSOF WORK - ,-- . <br /> �COM9INATION • ' • � � �� � <br /> �BUILDING �PLUM81Nfi ❑MECHAN�CAL OuEW �/�DOIT�UN GALTEIlAf10N_ O��U'n��� . . ' � <br /> VA4UATIONOFWORK []DEMOl15H ❑FENCE ❑SIGN ❑::�VIMMINf: POOL ' � � <br /> 5 L.ayfl� �prH <br /> OESCRI6E WORK ' <br /> ��/)V /��n w c r � Fro i7e n . OLL V . • ' . <br /> vRoroseo use • 07HER P�E 175 OR APPROVALS <br /> . .jx -E'ZONE .� SPECIAL USE . <br /> LlGAL DhSCRIPTION OF VfIOPERTY lSMOW UELOW OR AiTACH VARIANCE � SNORLINE • � •- <br /> FOUH COP�fi51 � <br /> 10T--BLOCY.—OF �f��/ r/���:.vL_i n'�� � ' � <br /> SEPA CHECK LIST REQUIRED <br /> - 'lz L - ? a � !.i l.oT Z�i' �.�ss o� " � {� NO � <br /> a �r�ri� r�v at �nc ' LR� � � -� <br /> �oe aooAEss . �MECHANICAL �' <br /> BZ?r� Cowcra. �i� e . <br /> TVYE OF ENERGY ELf.C. <br /> DlUM61NG � ' . ❑�:ns O <br /> , NO. TYPE OF EOUIPMENT. FEE <br /> - AtFlCOND.UNITS-H.V.EA. .�S' � <br /> �— T <br /> FEE -.. RkfRIGERATI0NUN1�$ N.N. EA ���,_�_ � . <br /> NO. • TYPE OF FIXTUf�E OR ITEM S -� OO�LERS H.v, EA. � � <br /> � pA1H TUUti � �. � FORCED AIP SVSTEb�+ P.T.U.MEA. � i_ � <br /> CtOTHES�'�nSHEfi � � _. . --•-• -�� � <br /> UISN YlASHEftS � . _ ----- ---• ' -'�- � �� <br /> Dfi1NKING FUUNTAINS � SOACE &VlALI NENTERS •- P•T•U. � <br /> Fl OOH O(�A�NS � � <br /> UNIT l�EnTEPS 'B.T.U. .��� <br /> / KITl:11EN ti1NKS & OIS� � EVAPOHATIVE COOLEHS ___� �. ' �C <br /> Nl111 SINIiS ^ � <br /> � CLOTNESDi�YERS —T-- <br /> NOOF DRA�NS Rn�N LEAUEf1S ' yEthTILATION FAN� , <br /> �HO\CEH BATHS qpNGE HO00' � � <br /> 5[RVICE S�NY,S � � � <br /> yUMPS - yEWP�GE �UMY _ AIR HANOIIN(:UNIT � . _ C.f_M_� „�_ ' <br /> � ' _'.� '_"_ -.: . <br /> Ufi1NAL5 � � U _ . ...."_'•...._.... . _.. _ .-. _""" ' "_"T <br /> � WATEH Cl45LT5 � WATEIi NEA7ER_.._ . _ . . .. - -• --�-^- <br /> T WAIEn I�EATEIIS - ELECTfl�C ����U FAC. BUIIT FIREPLACE !Y CMIMNEY ,_ _ � <br /> WASH BASINS • �.K1 � __ . _ . _ _ . "__ ___�.___ <br /> / CAS. SVSTEM: h0 OP OVT�F.15 _ � , L�--- � <br /> LAUNURV TRAVS , - �- � �SUO TOML 5 _^.� pd - <br /> . � ��-'_��'- PEHMIT�� 5 �� <br /> � -�- , TOT11LfEE 5 __,�C� <br /> — SU6 TOTAL � THIS VF.I�MIT OECOMES NVI�L nND VQ�U ❑� W����K t?H CONSTflUG <br /> PEi{MIT S � �U TION AUf11Un1'LED IS NOT f.(I�AMLNC[ll W�TI/IN 1?O U�Y.,PR IF <br /> ' TOTAL FEE I/ J CUNSTR��Cf10N O� WOIIK 1::iUtP'I:NOCD OR /�On��DPNED FpR A <br /> VEf110D OF 170 DAYS AT ANY f�Mt AFTEH WOf1K �S CO��b1ENCtO. � <br /> NATER SERVICE 512E ✓ � BLDG.SUPFLY S12E � ���qE11Y CERTIFY TIUT I IIAVL �EA�� n��n EXnMINCD T���S ��� � <br /> „ AN c A w UnCK NkAfi YANDSETLACR'. PUCATION AND KNOW TIIE SnRtE Tp IIF TfiUE ANp COIiItf.CT. AI.L <br /> � /e� PROVIFJONS OF lAWS AND ORO�NANCES �.OVEfIN�NG 7H�5 TVPE <br /> l n t-_�.1- 7���' (�./�T� OF WUNK WIIL BE CO�APLIED Y�1T11 YiMETNER SPECIFIEb MEREIN <br /> �Y � OR NOT, THE GRAN:ING OF A PER6IIT DOC.^. NOT�VNESUME 70 <br /> USC YUNt LUl AHlA VACANT SIiE V�VE AUTIIORITY TO V�OIA(E UN CANCtL TI�E YRUV151pN5 OF <br /> {J�� . ' ❑VES ❑N� ' ppTNEP[IIFORMANLEOf CONSTHUC7 ON�TIN(:CONtiT��UCT10N <br /> Y � <br /> TYPE OF CONST. UCCUVANCY GHUUP UN10S �WiLLING ' <br /> S�2E OF UIOG. NO.Of STORIES MAX.00C.LOAO J n �.� �' j n , ,� �__�- <br /> ( �i/� % � <br /> �%.<j� xJj6� � ' • SiGNnr(UREOFCONTFl�UT��'A4�NT OATE <br /> fIN!'.:PNINKLL/IS i <br /> I INE ZO'Nk IIA::tMkNt RtOU1HE0 lANC11hCK NUMOGfi YLAN Cllkl'Y. Fbl <br /> �/D. ❑Y[5 �j0 /� F'!C NECEIPT Nf�. <br /> PkGAL'CONDITIONS: �`� `� �I vO � • �' •.�•• <br /> '"'/....--�y... .... 'VALUATION FEE <br /> T�J/ A� S�{iIG/i f�� ///i10C TC� _ FEFS _ •_-_-T-- � <br /> I <br /> /�'�i.�� � i.t>iT_.Gf !�! ( fs it/%�y/i1(,i _ _ ._ <br /> � /7 /, � <br /> ITVF:� . OUILDING s G�V�'lL� ,,'��..�—_ <br /> • I " " �..�. ' t"»' <br /> � PLUMIIINO � ! IG ��U <br /> iEPA REYIEW COMPIETE � LIYES ❑ NO •••- ��"----"' " , (� iOU <br /> contacf Plann�nq dapf. nnEcunHic�i . _ . '._..... <br /> OTMER � <br /> i . �..��' <br /> � SEC.7071�1 � <br /> .iutwnecurl�u�r: •uw>�n��uu�r �Miv�o O�uw•�I�r PENALTV _.._'_"^_... __�......�.....- <br /> � � � � 70TAL � � <br /> ._._ _�_� _. " . . . .� <br /> . <br /> 7 <br />