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� C�NSTRUCTION �� 3�%3 <br /> PERMIT APPLICATION 9����� <br /> COMBINATION • BUILDING • MECHANICAL • PLUMBING <br /> OWNhH MAILADDIItSS ZIP NHUNh <br /> � <br /> /�-�G,� � l-. =RR 3.�1_�rE!/=��'rr �vc fi%/'�m l� �- q <br /> AHCHITL IUHOE51GN6H MAILAODNE55 PHONE LICENStNU <br /> GENLRA�CONTRACTOR MAILADDNE55 PMONE UCENtiENU. <br /> MECHANICAICONTRACTOR MAILADDPE55 � PHONE LICENSENO. <br /> PLUMOING CONTRACTON MAIL ADORESS PHONE � UCLNSE NO. <br /> �{'�p1�IjT C1A550F\YORK ' •_- <br /> ❑COMUINATION � <br /> � OUILDING �PLUMUING ❑MECl/ANICAL <br /> ❑NEW ❑�1�DITION ❑ALTEIIAf1UN ❑1iL1'nlll . <br /> VALUnI lON OF WOAK <br /> 5 - �O� � � ,1�/,/' ❑�F610�ISN fENLE ❑$IGN ❑'i\YIA1MINti PU .� ��� <br /> �� 4TN <br /> o��aara�W���K � - � �,_ �7T <br /> � i1� FNe r `�i ll'u N 17��?-1R�s« ,!' ?d v,v. � C/l� v_ <br /> PROM sEo use �c, � OTHER PERMITS OR APPROVALS <br /> �-7i F/�/VC°T_T �RdPd�''X _ � REZONE �( SPECIAL USE <br /> FOVq�C�F.�CI'IPTION OF PROPkRTY ISHOW OCLOW UR ATTALM <br /> /���}} ���7M1 �.VARIANCE L� Sh:ORLINE <br /> LOT '�6lOCK�OF_1.(l1—Cfl� <br /> 5 E PA CHECK LIST REQUIRED <br /> — e , % L� YES , <br /> Lj N O <br /> �_ <br /> JOO ADORESS � <br /> �� � (f�, � �MECHANICAL <br /> PLUMISING . TYVE OF LNENG V <br /> []�:qy n[LFC. <br /> ___" '"___._. _.... "'__ <br /> , NO. TYPE OF EOUIPMENT _ , ._ FEE <br /> AIR CONO. UNilS-/1.V. FA. . . . _. .�.5" '_""�-___- <br /> "___ __ . _. .__ . . __'_' "_""' "_"'. ..'___-�'_ _.__r— <br /> NO. TYVEOFFIXTUREORITEI.� FEE 11t�fRl(i[RATIONUN�f:: IIV. Cn. __Y_"___1_ <br /> NAlll lllllti $ OOILFRS IIP CA. _ .•. ..-.."""-�'-' I <br /> � CLOIH4$ 5Y�1$NF.Ii � - �FORCED A1�1 SVSTEN.S 11.T.0 MCA. �_T- <br /> � _' _...."___ '_'. .. . ___ -L___ <br /> Ultil l 1Nn5`f[��S r} � <br /> URINKW[i FUU>1TMN5 � - -- ' '"'--... _-.." ----- <br /> FI O(7N DHl�It15 � _ � SNAC[ b WALL NEl�1GR5 - 0 T.U•_-- ` _ � <br /> --�' UNI1 11EATERS II.T.U. � � <br /> Klll'JItN .':INKti ti UISP. � ' ---' -------' <br /> , UNISIPJKS - � -- EVnf'OHATIVLCOOLENS __'__"'___r"'�—.r—_ <br /> - - " - '--'---"'"-'— -� J CLUTNISDfIv[RS � _T� <br /> IiOflh OHNtJti HAIN LCl�UCHS I --._'_'__.- ' - <br /> _"'__ <br /> tiHf1R'f:H f�A1H5 � V[NTILATIONFAN <br /> — _- _ '"-__` -- <br /> 'iC��VICF. SIN✓.5 RANGE HOOD � <br /> _'_____ '____ ----r— <br /> SUtdP:i � S[lVA(i[ PUh7P '�- -"'"-----""" <br /> _'__' AIN11(1NDUN6UNIT C.f.M_....._.. ._..._"._l <br /> _. .�_ <br /> ._._.._ .... ..... <br /> UNINALS � - ."""___' _ ._.. 1 <br /> lVnlf H CLOtiF.TS � . . '_._. ..... .-. . . � . ..�.. �-- <br /> �YlA1L11 HI.ATE11$ - ELECIHIC 1 . _ ..WATLR IIEATER . " "'1.'__. <br /> �— FAC. OVILT FIHEPIl1CL M� C��11dN6Y � 1 <br /> \YASH I4AtiItJS ' 1 .. _ _' ' " _ -' . . . . . "___ . . �.-."-�'--- <br /> LAUNUftY TIIAYS _ 6A5. SYSTEMr_NO ON DVTLI IS L�_ <br /> . • .. —___. ' '" " .. . . ... <br /> �Ufl fUML 5 I <br /> - --- -- __ _.. ._._.----r-- <br /> — ' � �-' - "---' PEIlAIIT S <br /> _—_ "._._.__. ..__.._.._. "____'l- <br /> ' _..�_."__ <br /> � " - TOinIFF! 5 I <br /> SUO TOTAL 11115 Yf.f�h11T OECOh1E$ NUI l �ND VQ�U II \YUI�L' �lN f.UNSTfiUC <br /> {'EIIMIT 5 T�nri l�Uf110flIZCD I: NOi CO)dA1LNC[U \YITIUN VD UAV::, OR IP <br /> TOTAL PEE —t----i CUN!iTHUCf iON Ofl \YUIIK i5 SUtiI•I.NOCO O11 AO(�NOOVCU i0{I A <br /> WATCH S�NVIC� $I7F f3lDCi. SUPPI.V $I7F ����nIGU OF 110 DAYS AT ANY fIMF I�F iLN�Yf1fIK L':C���d6�l.NCCb. <br /> � 1 Ilf NLIIV CCIITIFY IIIM I I�AVf: IitAD ANU C.`(ACIINI D 11115 AP <br /> � ..t � A f S� UACK NLAHYNlD5tfUACK PUCATIbN /�NDRN01YTliCtb\M1IFTUIIhTHVCANUCOIiIIlff. ALl <br /> � Pq(1V1':IONS Uf 1 AYJS ANU fIHnINANCES GUVCIih�NG t�nS TYYt <br /> � ; OF WOISK W�LL F3E COh1PLIF0 WII�I Y1��ETr1E�1 S�'fUFIlU 1�ERUN, <br /> U91 2UNL LU7 Alll A V/�CANf t8:1 -�- ' UH NDT. TIIF 6f111N�ING Of A PERAI�T [lOL!: NOT PI�CSVA•.0 i0 <br /> UWE AVIIIURITY TO VIOLAfk OH Cl�NCLL I11[ PqUVi$i7N� OF <br /> ❑YE$ ❑NO , ANY OillCll STAT[ OIl LOCAL t AW IICGULAi1Nt:IlOM:T1IUCTION <br /> OR 711[ PLfiFONMANCE O� CONSf ftUCilqN , <br /> TYPE UI�CONST. UCCVNAtJCV GRUUY NU.Of OWLIIIN(i i <br /> UNITS /� <br /> SIZC OF OLDG. NO.OF $TOfiICS MA%.00C. IOAD x �� � �/- n n /� / - <br /> � �J y � <br /> � _ 91 . ATUHL( 'CUNTRIfC7 ❑ORAUTII.AUENT DATL <br /> IIHLZ(1N1 �- IIA':lMlfJl Illif`il`IIINKIIII$ <br /> , flLOWF1EU � PL.:NCIU.CFNUMIIlfI PLANWLLG: ILL <br /> � ❑Vt5 ❑NO fLl IIEGEIPf Nt+ <br /> sr�an�cor+oixior:s�. <br /> -�— - . ._�--F[ES ..Y�" VAWATION _ FF.E. . . <br /> _—_ ___—'_.�_'—_ _ '.'.r__' <br /> _ � <br /> --•�_..._�___.._._ — _ _�__� <br /> __...----- -- " i <br /> _.�_._ _._ eui�oiNc s �j� � ,j � _. <br /> i . . __._ — �- -....._.._. ._ ..r-•-- <br /> . .._ � <br /> SEPA REVIEW COMPLETE � ❑YES ❑ NO � ��<<�MIIWfi -w'-, ._ � <br /> i <br /> MLCIIANICAI � <br /> conlacl plonni��q depl. �.- . <br /> OTII[R � <br /> — -----T— <br /> �..uc���ur��turtlu�r �v��achu�lu�r. u�wOvlounwueKl��♦ YENALTV.___ SEC:JOJid _... "' _ . � —. <br /> _ i._� <br /> • � � TOTAI � � <br /> I <br /> �' <br />