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� i�:l' I�^l't'l!ilL`f`l1 <br /> =�T� �f CG'P�STRUCTIOiV �verett <br /> eVe�etit PERMIl' � <br /> ci.r ncu rsversae <br /> [vFPEii.c:asnC�GiOJ <br /> 9fi1]I <br /> ^�°' °° �°""°'•��° BUILDING MECHANICAL PLUMBING <br /> �ev[tavucr�r <br /> OWNER MAIL ADDRESS 21P NHONE <br /> Tr�;'� �?''��L'.7C '37'�.�7(r <br /> ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br /> GENERAL CONTRACTOR MAII AO�RE55 PHONE LICENSE NO. <br /> MECHANICAL CONTRACiOR MAIL ADDRESS PHONE LICENSE NO. <br /> Pl.UMBING CONTRACTOR MAIL AODRE55 PHONE LICENSE MO. � <br /> ^�'%TTr�a':<y,t irs'�^,y m ' <br /> PERMIT CLASSOFWORY. — ? <br /> ❑9VILDING �PLUi.401NG ❑MECHANICAL z <br /> '�NEW ❑ADDITION ❑ALTERATION ❑fiEPAIR ~ <br /> VnLUATION OF WORK <br /> � <br /> 5 ❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMIVG POOL W <br /> DESCRIBE WORK a <br /> 276 <br /> PROPOSEO USE MECHANICAL <br /> 'YPEOPFUEL �OIL �NAT. �LPG. �ELEC. <br /> LEGAL DESCRIPTION OF PROPERTY �SHOW I3ELOW Oa nI1nCH GAS <br /> FOUR COPIE51 <br /> NO. TVPE OF E�UIPMENT FEE <br /> LOT BLOCK—OF qlq COND. UNITS—H.P. EA. 5 I <br /> REFRIGERATION UNITS-H.P. EA. <br /> BOILERS-H.P. EA, � <br /> �GAS FIR[D .�A. UNITS-TONNAGE EA. <br /> � FORCED AIF SV,^,TEMS-B.T.U. M EA. I <br /> J06 AO�RE55 y I WALL HEATEflS-B.T.U. M <br /> x� ��� ���� -~ ��-� UNIT HEATEPS-B.T.U. M I <br /> EVAPORATI'JE COGLcAS <br /> PLUMBING CLOTHES DRYEqG � <br /> VENTILATIONFAN <br /> RANGEHOOD � <br /> NO. TVPE OF FIXTURE OR ITEM17 FEf AIR HANDLING VNIT— 0.F.M. <br /> WATEIiC�OSETITOILET) g INCINERATOR � � <br /> pATHTU9 <br /> LAVATORY IWASH BASINI � <br /> SHOWEF � <br /> � Y.ITCHEN SINK & OISP. SUE TOTAL 5 <br /> DISHWASHER � — <br /> LAUNDRY TRAY T PERAIIT 5 <br /> TOTAL FEE 5 � <br /> CLUTHESIVASHER fHIS PERMIT BECOMES NULL ANO VOIO IF WpRK OR CONSTqUG <br /> IYATEF HEATER TION AUTHORIZED IS NOT COMMENCEO WITHIN 1?0 DAVS, OR IF <br /> UqINAL CONSTRUCTION OR WORK IS SUSPENDED OR AdAN�ONED FOR A <br /> CHINKING FOUNTAIN PERI00 OF 120 DAYS A7 qNY TIME AFTEfl WOFK IS COM�IENCEO. <br /> FLUOR-SINK OR DRAIN I HEFE�Y CERTIFV THAT I HAVE REAO ANU EXAMINED THIS AP- <br /> VACUUM �R�AKERS PLICATION AND KNObV THE SAME TO BE TRUE AND COFRECT. ALL <br /> — f-- PROVISIONS OF LAWS AND OFDIN�INCES GOVERNING THIS TVPE <br /> ROOF- DHAINS-RAINLEADERS OF bVORK WILL DE COMPLIED VJITH YJHHTHER SPECIFIED HEREIN <br /> SINK ISEPVICE-BAR, ETC.) � OR NOT, 7HE GRANTING OF �. PLR\VT DOES NOT PnE5UM11E TO <br /> ^IVE -.UTHORiTY TO ViOL1T[ O(; Cr1NCEl_ TP�E PROVISiONS OF <br /> - iCJ1' �,TH@R ST�TL OFl LCCAL l ,�Vd REGUL�TiNG CONSTI�UCTIDN <br /> _ UR "i HE PGHFOHMq`J(C OF C��:'STf�UCTiON. <br /> SUB TOTAI. <br /> PERMIT 5 <br /> '�OTALFEE 5 <br /> x :s�r :-�� _ �• — 2/h.'j�G <br /> SIGNAiUREOPCONTRACTufiuIVAUTH.AGFNI DATE <br /> I SIDE VAflD SETOACK STREET SETCACK REAR VAFDSETBACK PLAN CHECK NUMDER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> US[ ZONE LOT AREA VACANTSITE <br /> O�ES ❑No FEES VAIUATION FEE <br /> TVPE OF CONST. OCCUPANCV GflOUP NO.OF OWELLING <br /> I UNITS � <br /> I <br /> SIZE OF BLOG. NO.Of STORIES MAX. OCQ LOAD �UILDING S � <br /> I <br /> PLUMBING 1r�IM <br /> FIREZDNE BASEMENT FIFESPRINKLERS ar w <br /> REQUIFED � <br /> ❑VES ❑NO MECHANICAI � <br /> SPECIAL CONOITIONS: pTHER � <br /> I <br /> - - PENELTY SEC.3031a1 1 <br /> � � <br /> TOTAL t�� <br /> _ �i! f� <br /> PERMIT VALIDATION <br /> WN[N PROPEHLY VALIDAT[O (IN THIS SPACEI THIS IS VOUR PERb11i <br /> I <br /> I <br /> � APPI,IClTIONACCEPTED�Y: PLANSO.FCKfOCY. APPHOVEOfO(11SSUAbCE�T <br /> � '• �'s <br /> I :{ <br />