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_._ IIIL'I[t'I'I111IY'11 <br />VV1Y�`G\��1YV �4 _ <br />�. pp <br />CI I Y ell <br />m,rf <br />, <br />�. \i <br />(:1I Y IIAI 1 74111/41, <br />IVIIfI II. -WA II37111 <br />COMBINATION BUILDING • MECIIANICAL <br />PLUMBING <br />_AT/ <br />!J <br />�- <br />MAIL LLSG _l LEI <br />� <br />IN` <br />(�(A�U_UIl <br />(V� <br />'' Y�-�-tea` ) �IiQ �f� <br />2�✓Y•-I-IUI <br />.�•` 1-I <br />(... <br />Ali 1:1111fC1 0f1 UY.:1(iN <br />It l/ <br />MAIL ADDRESS F O P/IU <br />SE <br />LICENSE NU. <br />_._. ___ _._ <br />(it,NLIiAI. CUN IAC11 <br />_ __ _. _-._�_-__.___. <br />MAIL AU}� 5 V110NL LI N, N <br />_ <br />(�Ip <br />MECHANICAL CUNfHAC7OH .__ MAIL OR Ss L <br />I'Lalluli{I N(i CUN7IML ( MAIL AUU)/E+ a <br />I'L Ii MIT ---_----_-_------- CLASS OF WORK <br />❑ COMBINATION <br />❑ BUILDING ❑ PLUMBING ❑MI.CIIANICAI <br />❑NEW <br />VALUATION OF WORK__ -- -----^- - <br />❑DE MUL IS II <br />$ <br />Y11UNE LICENSE NO. <br />PHONE LICENSE N <br />❑A00171(1N ❑ALTERATION REPAIR <br />❑FENCE ❑SIGN ❑SWIMMING POOL <br />----- <br />DESCRIBE WORK <br />" <br />PRorosED Uft <br />MECHANICAL <br />TYPE OF ENERGY <br />❑GAS ❑ELEC. <br />LEGAL DCSCHIPTION OF V OPLRTY ISHOW BELOW OR ATTACII <br />FOUR COPIES) <br />LOII ) BLOCK OF <br />�-___ <br />TYPED EQUIPMENT <br />FEE <br />.NO. <br />AIR COND. UNITS-1 .P. E_A. <br />fiEFli lOE RATION U ITS- .V. EA. <br />5 I <br />T.— <br />___ <br />- <br />UOILEfIu H.P. EA. <br />FORCED AIR SYSTE S-l.T.U. MEA. <br />1 <br />O <br />- ME N Ino' <br />M <br />JOB ADD'(\ESSS (� <br />SPACE HEAI'C - D.T.U. <br />�— <br />_&_WALL <br />UNIT HEATERS -R.T.U. <br />,")O1 <br />PLUMBING <br />_ <br />EVAPORATIVE COOLE <br />CLOTHES " f YE'IS <br />__ <br />-�— <br />-" <br />No. <br />---- <br />TYPE-6 FIXTUIIE OR ITEM <br />IIAI II TUNS <br />- <br />- <br />-�- <br />- <br />___ <br />... <br />VENTILATION FAN <br />RANGE HOOD __ <br />nits i1nNUUNG UNI C.F.n7. <br />_ <br />WA7ER IIEATE -- <br />- _ ... __. _ _— --_. <br />F AC. IiU1LT FIR, PLACE f C ILiNEY <br />- - - '-- - <br />GAS. SYSTEM. NO OP OUTL TS��_ <br />_"'------"- —SU TOTAL S <br />_______.—__ <br />I <br />FEE <br />S 1 <br />r- <br />I <br />r-- <br />1 <br />ClA li/F:51YA51EH <br />,j <br />UIt;H WASH@I;g <br />I <br />1 <br />I BINKING FOIL THINS <br />I <br />_ <br />FLOOR DRAINS <br />1 <br />I <br />KIICHEN SINK:i U P-"----- <br />-r- <br />1 <br />- <br />BAtlSINKS <br />--�__ <br />PE MIT 5 <br />.._..__.. .._.__. --_.- <br />r-- <br />'—� <br />'-"—" --`-'- --''"" <br />Ii00F BRAINS AIN I.EAUC RS <br />7UTAL FEE $ I <br />7HIS AU7f-PTIMUIT IIECO IS NULL AND VOID IF WORK OR CONST FI I <br />iION Al1T nORIZiU IS NOT COMMENCED WITHIN 120DAYS, Ofi IF <br />CONStRUCtlON OR WOIIK IS FUtiPENDLD On ABANDONED F(:R A <br />PERIOD OF 170 DAYS AT ANY 1 IML' AFTER WORK IS COMMENCED. <br />111ERERY CERTIFY IRAT 1 HAVE READ AND EXAMINED T1113 AP <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING TWS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED !1EREIN <br />OR NOT, TIM GRANTING OF A PERMIT DOES NOT PRPSUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OJHE PERFORMAn10E OF CONSTRUCTION. <br />SHOWER BATHS _ <br />;iF IIV ICE SINK" _ <br />SUP.11':' SEW GE 6IP <br />' <br />U HJNALS <br />WAIEH CL ETS <br />11 ATERS - LECI'HIC �— <br />I <br />_WATEfI <br />WASH D INS <br />1 <br />_ <br />LAUNO Y TRAYS <br />' <br />( <br />HATE II SERVICE Sli <br />SIUE YARD SE tIIAC1 <br />USL ZONL _ <br />TYYL [H C(INti T.--- <br />ULDG. SUPPLY <br />DSEIUACKPL NCHECK NUMBER PLAN CHECK FEE <br />FEE IRECEIPT NO. <br />OYES ONO 1 FEES <br />SIZE OF OLbC. <br />NO. UI StU111E5 <br />MAX. BCC. LOAD <br />BUILDING <br />PLUMBING <br />I IRE ZU'NE <br />OA6l AA I.IiT <br />RLOUIIILO <br />fl LOUIHEO <br />I <br />❑YCS ONO <br />KIECIIANICAI. <br />OTHER <br />I <br />i <br />!;"I CIAI. CONDITIONS <br />VE N AL I <br />SEC. 703(of <br />TOTAL <br />1 <br />PERMIT VALIDATION <br />Will N 1'110111 Hl Y VAI IDAI(D ON 7IIISSPACE) THIS IS YOUR PL MIl <br />nl'1'111 MtlM ,\I \J PII11111 <br />IPI'\H: u111M1111♦ <br />IM•Ym IYI IIIUIUI..1�h1u1111 <br />lD <br />ADI_)IiGSS FILE <br />