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c <br />thc Ercrgrecn <br />��, Y o�- <br />evereti <br />urr unu �yqenas <br />cvtnni r�asnrvcrm: <br />98I01 <br />°"`°``°^'^'°�"° BUILDING <br />ocvEiovrntrvt <br />NER I <br />=at:icr Ca�-:1son <br />COIVSTRUCTIOlV <br />PERMIT <br />MECHANICAL FLUMBING <br />AIL ADDRESS ZIP PHO <br />331 ito,�t "� >::":t <br />?1Ci!: Cun3tr��ctior: 17^5 Bro��iarav <br />❑ 6UILDING � PLUMBING � MECHANICAL <br />❑NEW ❑AODITION ❑ALTEFATION �AEPAIR <br />VALUATION OF WtORnK <br />5 L�J:�',/.V:� ❑OEMOIJSH ❑FENCE ❑SIGN ❑SWIMMINGPOOI <br />DESCRIBE WORK ' <br />re�eo si�iRylr.s - r�plac3 ui��h cor:.,,oQit.io�: <br />PPOPOSED USE <br />MECHANICAL <br />TYPEOFFUEL �OIL �NAT. �LPG. � <br />LEGAL �ESCRIPTION OF PROPERTY ISHOW 6ELOW OR ATTACH GAS <br />fOU COf?.I c � <br />�or��� ��� BLOC�7� oF ilQ�'�'�`�I °�'''Il��Qh NO. TVPE OF EaUIPMENT <br />AIR COND. UNITS—H.P. EA. < <br />FEFRIGERATION UNITS-H.F'. EA. <br />BOILERS-H.P. EA. <br />G/15 FIfiED A.C. U�IITS-TONNnGE EA. <br />FORCED AIR SVSTEMS-6.T.U. M EA. <br />JOB 114pqES$�1 � WAL� HEATERS-6.T.U. M <br />� " UNIT NE.OTERS-B.T.U. M <br />EVAPORATIVECOOLERS <br />PLUMBING ri nT�c� �o��a� <br />p <br />NAL <br />NY.ING FOUN' <br />�Ofl-SINK OR <br />L <br />AIR IIANDI.ING UNIT- C.F.M. <br />INCINERATOR <br />� <br />w <br />m <br />� <br />� <br />z <br />� <br />� <br />� <br />W <br />a <br />2964 <br />SUB TOTAL 5 � <br />PERMI'i 5 T <br />TOTAL FEE SI � <br />THIS PERMIi BECOMES NULL AN� VOID IF WORK OR CONSTRUC� <br />TION AUTMORIZED IS NOT COMMENCED W�TNIN 120 DAVS, OR IF <br />CONSTFUCTION OR WORK IS SUSPENDED OR A�ANpONED FOR A <br />PERIOD OF 120 DAYS AT ANV TIME AFTER WORK IS COMMENCED. <br />I HEREpY CEflTIFY THAT 1 HAVE READ AND EXAMWED THIS AP- <br />P�ICATIGN AN� KNOW THE SAME TO BE TRUE AND CORflECT. ALL <br />Pf10VI510N5 OF LAWS AND ORDINANCES GOVERNING THIS TVPE <br />OF WORK WILL 6E COh1PLIED WITH WHETHER SPECIFIED HEREIN <br />Ofi NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PPOVISIONS OF <br />ANV OTHER STATE ON LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORM,INCE OF CONSTRUCTION. <br />7��i�77 i <br />X <br />SIGNATUfiE OF CONTI <br />SIDE Yl�HD SET�ACK STftEET SETBACK qEAR VAfl�SETBACK PLAN CHECK NUM1I�ER <br />IISE ZONE LOT AREA VACANT SITE <br />SPECIAL CONDITIONS: <br />❑VES ❑NO FEE$ <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />VALUATION FEE <br />LING <br />I <br />7AO BUILDING 5 � � � I l��r <br />I <br />PLUM6ING � <br />LCPS � <br />I <br />❑NO MF.CHANICAI � <br />I <br />OTHER � <br />I <br />PENELTV SEC. 303 (al I <br />TOTAL j <br />PERMIT VALIDATION <br />WHEN PqOPERLV VALIDATED (IN THIS SPACE) THIS IS VOUR PEqMIT <br />nr <br />R <br />