|
- - - �L�lS i RUCi;Gv
<br /> _ , .., ����V'ElT APPLl�ATf Of�
<br /> COA161NA710N • BUILDING • WIECIIANIC�L • PLUMBING
<br /> UWNLII ���,�_ '
<br /> .� MALL AUURLS$ ���
<br /> l'f4.Y._r J,�iomo ,,, � •�,-_ .; l 5 � YMUNk
<br /> aA���„«T-����������E�� � 9�zo y' 33�- i � � S�
<br /> MAIL AO�qLSS VNOHE
<br /> LICLNSE—N(j�•
<br /> GFNLRALCONfAnCTOfI
<br /> / M�+�L AUDIilSS VHONC
<br /> ^"QUY�•hC � � Q /A ` s p ' IICENSL NU. ��
<br /> MECHANICAL CUNTRqGTOR O � � ~ 1+ ' �, p� l.�'! vI
<br /> y • M:IL ADORC55 ^ PHONE l � I ' � �OU •
<br /> �lL_�t / /,�e�-h� LICENSENO.
<br /> YWMp�NG CON7FiACTOH '
<br /> MAIL ADORFSS
<br /> F�y?IJE�����NSE NO.
<br /> PGRMIT � m�' n �,
<br /> COM9INAT�pry CLASSOF WORK , _.�_ :
<br /> ❑OUILDINC �P�UMOING �MECHANICA�
<br /> VAIUATiONOFYlOflK �NEY/ ❑ADDITIUN ❑ALTCfIAflf]N
<br /> � [�' ❑HCI'AIN
<br /> �._.1 � 000 ❑OEA70LISH ❑FENCE ❑$IGN ""_'_"""'--
<br /> DLSCHIO[Yl qK ❑%�Y�MMING POp�, �
<br /> , PROPOSEO USE j
<br /> • 'r . /,•, . OTHER pERMiTS OR APPROVAtS
<br /> LlGAL L)F.iCf11PT1UNpF Y{(OPERTY ISHOW UELOW OR qJ7q��� ��1-1 RE IONE � SPECIAL USE
<br /> FOUR CUPIE51
<br /> �oT � e�ocw_Lov�l �c. p #VARIANCE � Sf'.ORLINE
<br /> SEPA CHECK LIST REQUIRED �—'
<br /> tI' YCS
<br /> 1� NO •
<br /> JOO ADDRESS �
<br /> ,., ,. . �� �. �.� .`.� ��.
<br /> � �MECHANICAL '�"�"--
<br /> PLUMt31NG
<br /> TYV( OF ENCHGY
<br /> ❑.A5 ❑E�CC.
<br /> . NO. TYp[OF EOUIPMENT ---T
<br /> NO. TYPE OF FIXTURE OR ITEM I���COND. UNITS-11.P. tp,� '""—"'—l--��—•FEE�_ -
<br /> HAIN IUUS FEE — �HC��nic;E�nii N � -._. .. 5 I
<br /> S _ _ O UNItS IIP C4� �--'Z��
<br /> CLOfNFS Y7�5NLH f:O1l FRy H.o. EA. - "-'•--' ' { '
<br /> LJIti11t7AtiHEH$ JT — .. . _, — __j__ —��� �
<br /> � fOqCEO AIR SYSTEAI� p.T.U. MEA. 1
<br /> DHIL'KiNG FOUN7'nl— h- •�y—' — '— —"'-'--- '_"' __"_=� --i .
<br /> FLOOH f]f1Ail:5 � - - ' -'—' , � ��
<br /> I:III'HF.N tiIN1:51'v UISY � —� S�ACE t. WALL,_HEATFNS �• H.t.U. � �—
<br /> U�lll `ilNh:$ �� UNIT IIEATERS fLLL'. —' 1
<br /> �100F DRAIWti qp�ry �_(F��E��y � EV.1vONnTNE COOLENS T �
<br /> � SHQ1\LH (lATHS � CL0T11L5ORYEnS --��"�--' —'-
<br /> SEIIVICGSIfd✓,5 VCNTILATIONfAN-- — .
<br /> SUM1+VS �� tiEIYA('E PU!.:P I _y..�nt_.� �IOOD — .
<br /> URItJnLS � -� � � � .
<br /> WATEq CLQSE.T$ � __I hIN IfI�NpLtN4 VNIT C.f.M. '
<br /> - _1� �` -- ---- - . ..-- -----.�•-•.--_ '
<br /> WNkq IIf:qI�E11S - EL[CTHIC - . ._ . �.
<br /> -..__�. .... .
<br /> - L. M�ATEH HEATEq
<br /> YlASH tlASINS " '. . .... ._.._._.. .r. . . _ _.... _ ._.. �
<br /> .._ -Z---
<br /> �� LAUNORY TItAV�- 1 '�' _ _ FAC. BUIIT fIREPLACE ro CHII.INEY � �. _ �
<br /> ' . _ . .� . ._ . .'_' ' _". --. ._ .
<br /> _ 6AS. SYSiEA1: I.Ip OV OV TL1 1$'--...."� '"' -"�"T�-^
<br /> . '�-___ `_ '- __--.. ... -�Uq TOMI 5 Il.�__ i
<br /> '�--�-_�". ' _ _--_- _- _.. '_'"PERMIT � 5 �t'-�'- � ...-
<br /> ,.UO TOTAL - '—�--..--'... `- �i
<br /> PEqtd1T . - . . _ _ TOTnL FEE 5 �Isl
<br /> ��---_'___ � Tlllti PE11�11T [IECO\1E5 NUI l I1NO Vqlt) 11 WUIII:�t�H CUN$Tf1�C
<br /> � TO7AL F[E C TION AVf1ipH�ZED �5 NOf Cp��RiLNC[O 1YRIIIN t?� U.�r!:. pq �F
<br /> IVATF.iI SCR1'IC@ SITE CUNSTHVC�ION OH wonK �:: �V::i�[NpEO on nnnNOovin vpq 1
<br /> BIOG. SUPPIY $12F f'[f110D OI' 170 DI1Y5 AT ANY flNk Ai TC.fI WOfIK �.^.Cn!dR�FNCkO.
<br /> ��:Uat� A A ' �i� a UAC1: N[AHY�pFy�yE�HA^�."K-" 1 IIC{iLOY CEIITIFY i11Ai I IIAVC fiCAD ANO C�(AG11NlD tlll$ Aa .
<br /> S� 2oF7 PLICATIpN AND KNOY/THC ,^.�\NE TOIih TfiVC ANU CUIiRCCi Al l
<br /> Uti! IONL ZDF� � �fiOVl^IpNS pF LAIYS ANU qHDINANCFS GUVERYiNG IHtS TVP[�
<br /> LUT AHIA VACANi t:ITL Of WUIIK WILL U[ COr,tPIIFD WItH YmETnElI ::VECtft:O II[HCN�
<br /> ��� 4 OP NOT, TMF (iRAN.-IN(7 pf� �E�nnr nocs NOT PRE$V!dF Tpl
<br /> ❑YEi �� (i1V[ AUT11(Jti1TY i0 VIOIAfF, pN CI�NClI TIIE Pfi<)V!SiONS OF
<br /> TYYG UF WN5T. � nNv UT1�[q STATE O�l �pC/�� �nW ItL4UlATINp pqNtiT�tU '
<br /> UCCVM/1NCV GqOVP n0.f�F p1YkLLlryV ON TM! P�qpOfIMANCG O! CVNSiRUCT10N. �TION
<br /> UNI:�� ��
<br /> •
<br /> SIZC OF p�p�, NO.OF Si ORILS ` �
<br /> �.IA� � �
<br /> 4D',��O ' / �«.�o.,o
<br /> ,- " ' emo ��- 7
<br /> I llll ZUIVh ' W,,�./.�L^1[M�/�' r �__ !� �"'
<br /> . _� ;IA1;tfdlfJi IIHI �1'��iNi LUIti l SIG A UI CI ppci,.�'�IIACIORORl1UTII.AGCNT L�-
<br /> �j � '� �a.n��..0 ,.�.�.....,m..�.o�....�„e,,..a,.m.., _ nnr[ '_'
<br /> . y�s _ __,_ �.,_ �o - , �.:����,� ': NUhil)!ll �������...�,:...
<br /> SPLCIAI CONDITIO Li: ❑ECEIPf N(�
<br /> I I:C
<br /> __._- - — •— ����✓'"�3�. ��5� 5v � -,,,�� %
<br /> --_____,-__'.—_ _' _.' .�F[[S _ VALUATION I � •.. F£E. .•.
<br /> � �'_"r__
<br /> --���" - _..__'- 1
<br /> � - �... ...'__�_
<br /> - -------_ , ����o�N� : �/ 29�.0� 23� �ov
<br /> SEPA GEY(EW COhiPLEI'[ � ❑YEg �
<br /> , .....---..._.._._ —
<br /> a ,�o ' �'lUMI11Nli +'-"~��
<br /> conloct Plonninq dopl. ..._ ..'—'---••- 'j/ i—
<br /> Id(CIV�NICAt (
<br /> � _ . _zs;__- .
<br /> `r Oi11G1 • �
<br /> �ritlCwbUrl�l4�11UFr ." �'�. �
<br /> •UMlUQlSIUYI ,-�"�^'�--.. � �
<br /> ' ' Y141OX�L`l�M.�[I Y\' I •��'�T��
<br /> .._ . IiNn.l1 V Sf.C. JOJ(LI
<br /> {Nr�l
<br /> 11
<br /> .��.��.�. ���.. '
<br /> �i. � - .—. .�.....��� •.�.... �. .
<br /> . i ._..L--_
<br /> ...__._..'- -- � ;U7hL �
<br /> "'__'. . _.._'__'. 1 I
<br /> .----.. _-----�----� -.. .....---�.._r.�_.._.1......____ ..._......,_....�.,..._ ..,1_,_....
<br />
|