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;-.PPLICATION F06. j,�,,d�'^�� �I`;►�ti'p� �w�;g;,,,�1. <br />,".E".,°'"° CONSTRUCTION �� 5`1 "d����C� _ eVf�"„� <br />cin or <br />� DerettMENT PERMIT ���I�-���G��U� <br />259-eB10 TO BE COMPLETED IN INK - PLEASE PRINT <br />� DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL O PLUMBING <br />Oa Df <br />M��1�00NE89 C�lv I�P PHOv( <br />/Sco/�dl �i�7�hc6t .93or/�°"-1i �!/R��rT��� 9h"lo� aJ-� <br />r�+o�¢ <br />❑ SIGN <br />tivnnlwn��wu�.. mni�.uu..00 • u• ���rt L�CE�ISE• <br />- �-� ��'�.�� �(' ers �y�s -%da � s�� �C, ya�� u���,cG �� y`do.� G.?a3-�•z-���: <br />rakC���NiULLON�u�CIOq MML�DORE95 CitY bP Pi�ONE IICENSC• <br />�WM6�NOfN11R<CID�1 M�ILADORE55 Gry 21P PIIONE �ICVRE• <br />GU55 O� K'ORY <br />❑ NEW ❑ AODI110N ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ W01�DSTOVE/FRPL.INSERT ❑ BUILDING RELOCAiION <br />ww�nou or won. �r.osi or rnnrtnuis nws ueoni ' <br />_�� <br />- J)errnu/�i��x- <br />�5� 0, e�i���i�� <br />io��..�� <br />G <br />y�� �/— "7 �`'/- 0// - DD <br />Pao�ecreooeEss <br />oZ.j �/ �/o <br />PLUMBING <br />WaTER CLOSET �TOILEt� <br />BATHTUB <br />LAVATO(iY�WASH BASIN� <br />SHOWER <br />KITCHEN $INK b OISF <br />C�ISHWASMER <br />IAUNDRYTPAV <br />CLOTHES waSHE� <br />URINAL <br />OfiINKING FOIINTAIN <br />FLOOR OANN <br />BACKPLOw PRE�EN"EHS <br />ROOF DRAINS — RAII i�EAOERS <br />SINN ISERVICE — BnR ETC � <br />� �+oHr 5E te�f.r. .. <br />16[ZONE <br />r��:e or co•rs� <br />sz[ or oio❑ <br />�IRE SPRIIJKLER'. <br />m PI q::J�p•i aCc tiv <br />ITEM <br />SUB TOTAL S <br />PE�MIT f <br />TOTALfEE S <br />nG�BSEIDACM 5�0[SEtBeCi <br />tOtePEA yqL�NiS�iE <br />oves ouo <br />OCCUP�NGYGROUV NO OfUWFL <br />m <br />�'lRNS <br />I HERC-BY CERTIFY THAT I HAVE FiEAD AND EkAMINED THIS AM1 <br />PIICATION AND KNOW THE SAME TO BE TRUE ANDCORREC7. ALL <br />PROVISIONS OF LAWSAND ORDINANCES GOVERNING THIS iVPE <br />OF WORK WILL BE COMPLETED JJITH WHETHER SPECIFIED HERE� <br />fN OR NOT. THE GRANI ING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUiHORITY TO VIULATE OR CAPICEL THF PROVI�IONS OF <br />ANV OTNER STATC OR LOCAL LAW RE(iIILATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTR�Ji,T�O�/. . <br />513A1.� REOfCONIRACTOROpROiH,����F�,��pafE <br />X �>�� y ��.� �.� ��-� /�� <br />MECHANICAL <br />FEE NO. TYPE OF EOUIPI <br />A/C — AMNOLG UNITS — H P. <br />REFRIGEBAiIpN UNITS — M P. I <br />BOILERS — B.TL1H P <br />GAS FIRED A.C. UNITS — A.T.U. <br />FONrED MA SVSTEMS — D T.U. <br />WALL HETIERS — D.T.U. <br />UNIT MEAIERS — B.T.0 <br />EVAPO�ATIVE COOLERS <br />CLUTY�'S ORVE(iS <br />VENTILATION F�N <br />RANGEHOOD <br />WATENIiEATER <br />WOODSTOVE <br />META� Flq'ePLACE 8 CMIMNEV <br />FIREPIACE INSERT <br />HEATPUMP <br />GAS P�PING <br />E%HAUSTFAN <br />Max occ iono <br />SU0T01'AL <br />PEfiF11T <br />PLPN CMECN NUMOER <br />FEES <br />DUILCING <br />UNItS <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BWLDING SURCHAI7G <br />STATE ENEHGY SURCHMGE <br />CE BY <br />PIIBUC WORY.$ <br />TOTAL <br />FEE <br />M EA. <br />M <br />M <br />FfE RECEIPlNO. <br />VALlI.1TION FEE <br />5 <br />PROPERIV OWNERS ARE f1E5FONSIBLE fOf DETERAfItJING AL'. <br />PPOPERTY LINE LOCATIONS AND RELATEU FASEMEtJTS. <br />