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_ <br /> �i�,. E�c.�.�t�; <br /> =�rYOF C01�1STR�UC�It7�i evereft <br /> eVei'e$� i�ERMIT � ' <br /> CItY NAIL 159:E65 <br /> NEfl(Tf,WaSNINLipN <br /> 98}DI <br /> °��' °o°�';a;,r�„ gI;;LDING MECHANICAL PLUMBING <br /> OWNEfl �y .�p�M1tAyIL��AOD�NESS �,yy.'21P y+y YHn�O�NE � <br /> Q.� V� �� �7 �w(i�'w� -�K.T �TirJ �.-'�i <br /> AftCHITECT OR DESIGNEq MAIL ADDRE55 PHONE LiCEN$E Yp. s.�-i� <br /> ,S,ii.l <br /> GEpN�E.�fl.A�ICONTriACTOFl MAILADOF[55 PHONE L�CENSENO. <br /> s)[�1[ <br /> MECMl1NICAL COIITflACTOF MAIL ADDRESS PHONE LICENSE NO. <br /> PLUMBING CONTRACTOR M/�IL ADDftESS PIiONE LICENSE NO. � <br /> W <br /> KI <br /> � <br /> PEPMIT CLASSOFtYOflK � , <br /> z <br /> �pU1LDING � MLUM6ING ❑MECHANICAL �5 F- <br /> �:,,:�^;��_t ❑NEW ❑ADOITION ❑ALTEftA'flpN OREPAIR � <br /> ��'y' ' VAIUATION OF WOPK � <br /> 5 CM_M ❑D[MO: '_H ❑PENCE ❑SIGN ❑SWIMMING POOL a <br /> 'j.r�.�Vr� <br /> DESCR'BE WORK <br /> t�is�oeY'tama�d � �2 2 3 <br /> PFOPOSED USF. <br /> c���,� ���� MECHANICAL <br /> TYPEOFFVEL �OLL �NAT. �LPG. �ELEC. <br /> LEGAI DESCRIPTION OF PqOPEFTV IpHOW OEIOW OR ATTACH GAS <br /> rou��ries� ^1� � � <br /> LOl'--- �IOCK—OF �;^ . NO. TVPE OF EOUIP�1EN7 _ FEE <br /> AIR CONO.UNITS--H.P. EA. 5 I <br /> REFFIGERATION IINITS-H.F. EA. —1�— <br /> I <br /> - �OILEflS-H.P. EA. I <br /> GAS FIqEO A.C. UIJITS-TONPlAGE EA. <br /> I FORCED Alfl SVSTF_MS-6.i J. M EA. 1 <br /> JOB �e 5 -y—VJALL HEATEAS-B.T.V. M <br /> 'j�('����y�� I _ '_" <br /> ���"�"""'�- UNIT HEATEflS-9.T.U. � M I <br /> EVl�POqlTIVE COOI.EFS <br /> PLI�MBING �LOTIiES DRYERS 1 <br /> VENTILATION FAN <br /> RANGEHOOD I <br /> N0. TYPE OF FIX7URE OR I7EM FEE _ AIR HANDLING VNIT�- C.F.M. <br /> WATEflCLOSETITOILETI g �NCINERATOR _ I <br /> �ATHTUB <br /> LAVATORVIWASFI�ASIN) —h I <br /> SHOWEF —� <br /> KITCHEN SINK tL DISP. SUD TOTAL 5 � <br /> __ DISHWASHEfl � F[RMIT $ <br /> _ LAUNDRV TRAV TOTALFEE 5 � <br /> CLOTHES WASHER THIS PERMIT �ECOMES NVLL AN� VOID IF WORK OR CONSTRVC- <br /> WATER HEATEF TION AUTHORI2ED IS NOT COid1.tENCED WITHIN 120 DAVS. OR IF <br /> URINAL CONSTflUCT!ON OR WORK IS SUSPENDEO OR AOANDONED FOH A <br /> OHINKING FOUNTAIN P�RIOD OF 12U Ol�VS AT ANV TIh1E AFTER WORK IS COh1MENCED. <br /> FLOOR-SINK OR DRAIN I HEREf3V CERTIFY THAT I HAVE REl1D AND HXAMINED TFIIS AP <br /> VACUUM BREAKERS PLICATION AND KNOW THE SAhIE TO BE TRUE AND COqqECT. AL� <br /> ROOF DRAINS-RAINLEADER$ P�OVISIONS OF LAWS 4ND ORDINANCES GOVERNING THIS TYP[ <br /> OF WORK WILL BE COMPLIED WITH N'HETHER SPECIFIED HEREIN <br /> SINK (SERVICE-6AR,ETC.) � OR NOT, THE GfiANTING OF !� PcRMIT DOES NO� PRESUME TO I <br /> -- GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISION$ OF <br /> — — l�NV OTHER STAT[ OR LOCAL LAW PEGULATING CONSTRUC710N <br /> OR TNE PERFOP.MANC[OF CONSTRVCTION. <br /> SUBTOTAL <br /> PERMIT 5 � <br /> TOTAL FEE 5 pf}/�jjry�.'/,. <br /> x '. '"/ •� <br /> SIGNATUREOFCONTRACTOPOflAUTH.AGENT D.QTE <br /> SIOEYARDSET6ACK STflEETSETBACK flEARVARDSETBACKPLANCHECK NUMBER PLANCHECKFEE <br /> FEE FECEIPT NO. <br /> USEZONE LOTAREA VACANTSIT[ <br /> ❑vEs ❑No FEES VALUATION FEE <br /> TVPEOFCONST. OCWPANCYGNOUP UNITOSOWELLING I I <br /> SIZE OF �LUG. NO.OF STORIES MA%.00Q LOAD 6UILOING 7�V, �1 <br /> PLUMBING I � <br /> FIREZONE [iASLMENT qEQUIflE�DKLEPS i <br /> ❑YES ❑NO MECHAPJICAL I <br /> SPECIAL CONDITIOYS: OTHEH � <br /> I <br /> PENFLTV SE0. 703(al I <br /> I <br /> -- — 70TAL Ly j� <br /> PERMIT VALIDA710N <br /> WHEN PROFERLY VALtOl1TED UN THIS SPACEI THIS IS YOUP�PERMIT <br /> APPLILnT10NNLCEPTE��Y�. PL�NSCHECFEDU': NPPqOVCOFOR1:50f.`,C[�Y <br /> 31YU11 I ��V• � . <br />