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. ; <br /> : ���'ERMIT APPLICA��ON � /�� ��a - i-G <br /> . . : . : . � . .- . :_ . � � z� 7�� <br /> � ' BUILDING MECHANICAL PI.UMBING ' <br /> OWNEN . MAIL AUUNt'+5 ZIY PHUNt . <br /> � _ <br /> � /.-� ��. L / �C .� _, �, . _,��„r:i=<'.P : •��; ., �j /'i, <br /> ARLHITECTOROESIGNEH MAILADDRESS ' �MONE / LICENSENO. , <br /> GENERALCONiqACTOH MAILAODRE55 PHONE LICENSENO. <br /> 5/L'�%i-!G�%l,'/S f/ C i f' /ilU[ Ofh'S SGOL�'L 5"Uc%Ci'Ff-.�.'j 5 7 -5 5 ,- p z � c:i _�'� .-i.� - r i._ ���� j�:� <br /> MECMANICALCONTflACTOR . MAllA00RE55 � PNONE � L�CENSENO. <br /> fWM01NGCDNTRACTOR . MAILADDRE55 ' PHONE UCENSENO. <br /> � . � CLASSOFWORK . . . <br /> NUMBER OF STORIES DBUILDING �PLUMBING �MECHANICAL ' <br /> BASMENT ❑NEW ❑ADOITION. ❑AITEHATION ❑REPAIR <br /> VALUATIONCF WORK '�` � <br /> �q,�) ��U � DDEMOLISH ❑PENCE ❑SIGN ❑SW�MM�NG POOL <br /> S (J C% <br /> DESCRI82ri0RK , �/, ' . <br /> i: �/ • <br /> _i�, .:_/Go Ci�C��-.._ LC�J ti K�<L ��_�LLL��-�.7 <br /> ... <br /> � PqpPOSE�USc � �/� . <br /> IECAL DESC���TION OF PflOPERTY ISHOW BELOW OR ATTACM � i../ <br /> . FOUR COPIE51 ' � <br /> �fC ��/ TCc�/� �j4 /'.sC Oii :y�J- - 7 �i ..�[�� � cc/ Cc'-� j C�:�.,� <br /> _ LOT BLOCK—OF ./� <br /> > <br /> ;:�' , �'f• l ��7 •/f, �� _-� .-tl Lt ./i�. / r�.�-i_ �r.rti i,�%�,S'��;• <br /> � /i.�_�T" ' � -� j�, -',� � ���� - ,/ iL-� i�". 7�:'.�'� .l� li� /7�/ ��;� �� <br /> _ - � , / :u r�'� ,��.i� <;G'. <br /> JOB ADDRE55 . ' � <br /> . . . ` ' <br /> PLUM�ING MECHANICAL <br /> — TYPEOFFUEL �OIL ❑GAS ❑LPG. PLOT PL�N <br /> NO. TYPE OF EDUIPt•1EN7 Draw plot plan <br /> NO. �'?E OF FIXTURE OR ITEM qlR CONO. UNIT$—H.P. EA. On baCk S1dE. <br /> WATE�=_���T ITOILETI REFRIGERATION VNITS—H.P. EA. <br /> BATHT:.o gOILCPS—H.F. EA. • . <br /> , LAVP-�^`!11YASH8ASIN1 <br /> SH0�1`-� GAS FIPED A.C. UNITS-TONNAGE EA. <br /> KITCF='•�"�K B�DISP. FORCED�+�F7 SVSTEMS-B.T.U. M EA. <br /> DISNtti-�-°9 WALL HEATERS-B.T.U. ht <br /> LAU\�7"' TPAY UNIT HEATERS-B.T.U. "d <br /> CLOT�S:.-SHEH EVAPOFAT�VECOOLEFS �- � , <br /> WATE� -E4TER CLOTHES DR�EPS ' . <br /> URIN-0L VENTILATION FAN � � <br /> ORIK6:'•= �OU�JTAIN RANGE HOOD ' • ' <br /> FL00=-:��K OR DiiAIN <br /> VACUC:' =�=P.KERS AIHN�INDLINGUNIT- C.F.M. <br /> '- ROOF :^>'.�5-H4IN�EADEFS INCINERAYOR ' ' <br /> 51NK ISE�ViCE-BAR. ETC.1 , <br /> ` v 'cr p`ILY BELO[? • . <br /> SIDEYAROSEinACK STflEETStTUACK REARYARDSET�AC � � � ' ' <br /> �)(', '�4. \. V�\��"�N��� , <br /> 6/SEZONE lOiAflEA VACANTSITE SIGNATUREOFGONTf1ACTOROflAUTH.AGF.NT OATF. <br /> ❑YES ❑NO r'EL''S (' <br /> � TYPE OF COfwii. OCLUPANCY GROUP NO.OF DWELUNG PLAN CK � VALUATION �'-��'� � I�^-� <br /> UN�TS <br /> BLDG PbiT =��- <br /> 512E Of 6lOG ND.OF STOPIES MA%.OCL IOAD MECH PA1T PLAN CK NO <br /> PLBG PMT <br /> — FIHE20NE BAS M N p�0U1REDNLER TOTAL `�L —� , • � ' <br /> ❑YES ❑NO 1 � <br />��. � � � <br />