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,,,�. �,.n,X,�.., ^O N�T R U CT I O N <br />��,�� <br />everei�: PERMIT PERMITNO 12H27 <br />GT�� MALl2i9�87a5 <br />efF4eir,van�3ezoi � r01'dBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING <br />OWN[R MAILAOORE55 GItV ZIP PHONE <br />nma ICNTTF 7814 TFTLNn ilR_ FVFRFmm 47A Q82�3 <br />G'.ICNIiECf OP OESIGNEP MAIL q�ORE55 CIiY ZIP PHONE <br />G[NEFPL :ONTAAGTOR MAIL A��qE55 GITY ZIP PMpNE LICENSE � <br />MEGMANICAL GONTNALTUR MRIL PDD8E55 CIiY ZIP PMONE LICENSE I <br />SELF <br />PLUM131NG CONiRFGiOR MAIL AO�PE55 CITY ZIP PHONE IIGENSE R <br />C`�NEW O ADDITION ❑ ALTERATION ❑ flEPAIR ❑ OEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />VAWAiION OF IVOFK <br />S <br />DESGRIBE IYORK <br />INSTALL WOOD STOVE <br />�OT_BLOCR_OF <br />1513 LELAND 9F2. <br />PLUMBING <br />No. TYPE OF FIXTURE OR ITEM <br />W ATER CLOSET �TOILEn <br />ZATHTUB <br />LAVATORY�WASH BASIN� <br />SHOWER <br />KITCMEN SINK 8 �ISP. <br />LAUNDRYTFAY <br />GLOTMES WASHER <br />WATER HEATER <br />URINAL <br />OflINKING FOUNTAIN <br />FLOOR �RAIN <br />VACUUM BREAKERS <br />ROOF DRAIN$ — RAl1:LEADEflS <br />SINK (SERVICE — 9AR, ETC.� <br />SUB TOTAL <br />PERMIT <br />RR[ZONE <br />APPPOVALS � <br />1. ENVIRONMENTAL CMECK LIST <br />2. BUILDING PLAN�. <br />3. FIRE HYORAYT <br />d. FIRE PROTECTION SYSTEM <br />5. GRADING <br />G. DRAINAGE <br />7.ENVIRONMERTAIIMPACTSTATEMENT <br />I HEREBY CERTIFY THAT I HAVE READ AND EXA�NINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORHECT. ALL PROVISIONS OF LAWS AND OHDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />'�.VHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PPESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION Orl THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNhjUREpF�ONTRAqiORDAAUiryyP12E0AGENi OAIE <br />MECHANICAL <br />FEE <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.A. EA. <br />BOILERS — H.P. EA. <br />GAS FIFEO A.C. UNITS — TONNAGE EA. <br />fORCED AIR SYSTEMS — B.T.U. M EA. <br />WALL MEATERS — B.i,U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTMES DRYERS <br />VENTILATION FAN <br />qANGE MO00 <br />AIR HAiJDLING UNIT — C.F.M. <br />METAL FIREPLACE 8 CMIMNEY <br />HEATPUMP <br />__ "� <br />f � <br />S <br />f <br />REAR YARD SETBACK PIAN CMECK NUMI <br />VACANT SITE <br />..VES . NO FEES <br />NO. OF DWELLING UIJITS <br />BUILDING <br />MA%.00C.LOAD <br />PLUM9ING <br />FIqESPRINKLEFS h�ECMANICAL <br />REOUIRED <br />VES ' NO <br />BY OATE OTHER <br />PENALTY <br />TOTAL <br />SUBTOTAL 5 <br />PEqMIT S <br />TOTALFEE f <br />PLAN CI <br />FEE I A�CEIPT N0. <br />VALUATION I FEE <br />E <br />SEC. 907 �a� <br />WHEN PROPEflLYVVALIOATE� (IN THI��.°lSC,FJ TMIS � xO�R�Ffi�T_[ti� -� <br />G S U / ) ��1 <br />� <br />N <br />FOR ISSUANCE BY � - Z R C C E I PT� <br />�, I/�Vi'�V ����U <br />P,DDR[SS fI�F <br />I 6 DSC 8 3 <br />� <br />� <br />