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-PERMIT <br />APPLICATION' <br />BUILDING <br />MECHANICAL PLUMBING <br />UIVNfiIi MAIL AUUHE55 ) ZIP <br />r <br />1'HUNL <br />NO. <br />ARCHITECT OR DESIGNGII MAIL <br />ADDIIES. PHONE <br />LICENSE <br />GENL'IIAI COIITFIACTOR MAIL ApDRf SS PHONE � <br />LICENSE ND. <br />• <br />MECHANICLCONT I�if�1On MAIL�AD0 hL55 •� 'P/M/O�I7JE/ <br />MECHANICAdill ,�Lhl-C�Jt�r�c�.�./19/c1��//`F g-jlt/y7,f�G�/� <br />LICENSE NO. <br />1 <br />x <br />U h1WNU CON ACTOR MAIL <br />ADDRESS PH N <br />LICENSE N0. <br />CLASS OF WORK <br />,� <br />�t.:CCIIANICAL ' <br />❑PU;h'aING [3 <br />NNUMBERoOFsSTORIES❑BUILDING <br />-_^- <br />AASIdEiIT <br />❑IJEI'J ❑ADDITION. VAl.l'ERM-ION <br />❑REPAIR <br />VALUATION CF YYO RY, <br />. <br />-- ❑OE(dDU51( ❑FCNCE []SIGN 05'YIMMIIJG <br />POOL <br />S <br />- <br />oesenme WORK <br />PFlOPO/JS CD L'S�E <br />L(:GAL UESC RtI'iION OF PFlOI'E RTY 15HOYf aELOW OR ATTACH <br />FOUR CUI•IESI <br />' <br />LOT BLOCK —Or - <br />— <br />JOB <br />PLUMBING <br />MECHANICAL <br />IYPEUI'FUEL ❑oIL ❑cns• ❑u'c. PLOT <br />PLAlI <br />• <br />NO. TYPE OFlOU1Ph1ENT <br />Draw plot plan <br />NO. TYPE OF FIXTURE OR li'Gh1COND. <br />UNITS-H.P. En. <br />back side. <br />WATER CLOSET ITUILETI <br />nCl°RIGS RATION UNITS-H.P. EA. <br />on <br />_ BATHTUB <br />60ILE R5-H.P. EA. <br />• <br />LAVATORY IIVASH BASIN) <br />-- <br />(AS I'IRCD A.C. UNITS -TONNAGE EA. <br />SIIOIYLR <br />KITCHEN SINK F. DISP. <br />FORCED AIR SYSTEMSA. Z) <br />DISH1Y15NER <br />WALL IIEATERS-U.T.U. M <br />L AUI:O?Y TRAY <br />UNIT HEATERS-B.T.U. h1 <br />CLOTNeS WASHEn <br />EVAPORATIVE COOLERS <br />._ <br />WATER NEATER <br />CLOTHES DRYERS <br />-- URINAL <br />VEIJTILATION FAN <br />DRII:KI♦3 FOUNTAIN <br />--- RANGE HOOD <br />FI-00?-SINK OR GRAIN <br />AIR HANDLING UNIT- C.F.M. <br />V ACUV:' aREAKERS <br />HOOF GRAINS-RAINLBADERS <br />INCINERATOR <br />SINK (SERVICE -BAR, ETC.) <br />• <br />SIDE YARD SET BACK S11lInL7 SLl BACK <br />REAR YARD SEI'OAGIc <br />USE ZONL LOT AREA <br />VACANT SITE SIG A VHE OF (JT CTUn OR AU 1'IL nGE NT DATE <br />DYES ONO L'E);S - <br />TYPE OI' CONST. OCCUPANCY GROUP <br />NO. ND. OF DWELLING PLAN CK <br />UNITS <br />VALUATION <br />llLDG PMT <br />51ze of nLoe. No. OF sronlES <br />MAX. occ. LOAD bgP.CII Pt•iT <br />PLAid CFC NO <br />PLL)G PMT <br />FIRE ZONE OASCM NT <br />FIHE SPRINK LCIL^ TOTAL <br />' <br />• <br />NF.OUII{ED <br />❑YES ❑NO <br />