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` � � � CONSTRUCTICi� � <br /> PERMIT AP!'LICATiON ��;���� <br /> .% ,� _7l <br /> COMBINATION • BUILDING • MECHANICAL • PIUMBING <br /> OYIfNtN MAILAUUIItS:i ZIY NMUNt <br /> ��n_ti'.%�_��•�1 T�.,c p, n. /-�„n �Z� � ��an.3 3sa-�Soo <br /> AHCHITECT Oil UESIGNEH MAIL AODNESS PMONE LIClNSE NU <br /> GENC'iAL CONTRA=TOR MAIL ADONESS �HONE UCENtiE NU. <br /> GII� N/,J /rIt'.s .SNC. /�.D I3C'�x .��/6 7 _3<J 3-G7.SLYJ �'�'-ON,- an/- ^ /_-sf✓ <br /> MECl/ANICAL CUNTRACT(lR MAII. ADDRESS � YNONE I�CENSE NO. <br /> F'�� R:�.�,�- ' , <br /> YLnUMtlING CUNTRACTOF MAIL ADORESS PMUNE IiCENSE NO. <br /> �7� s , / .-.----_.---- <br /> PGRMIT CLASSOF WORK ' <br /> ❑COM�INATION � <br /> �OUILDING ❑PLUMOING ❑MhCHANICAL _/�W �ADDIiIUN ❑AUF.fi/�II4q ❑11�1'nlll _ <br /> �N <br /> VAIUATION OF WUPK —.. --� ��'_�-' �""�--""- <br /> s �O n�� � ❑DEMOl15N ❑FENCE ❑SIGN ❑:i�VIMMING f•(101. <br /> D'cSCfilOE V�URK <br /> PROPOSEU USE / ( � �� OTHER PERMITS OR APPROVAlS <br /> ��Si�I�c���� j� REZONE � SPECIAL I;SE <br /> LlCAI.UF.tiC1UPTIUN OF YqOP� RTY ISHOW BELOW OR ATTACN <br /> rouec.o�pvi�ts / �,VARIANCE � SHORUN[: <br /> �oT�GLLBIOCK�OF!���`'�p�� �Sr,RrPS <br /> 5 E PA CHECK LIST REOUIRED <br /> I� YES <br /> 7� NO � <br /> !00 O.L 7 R LSS <br /> /23 � :.,�,._ �T� � M.ECHANICAL <br /> PLUMBING . fVPE OF ENEHCiY �, '^J �FLEC. <br /> . NO. TVPE OF E�UIPMENT FEE <br /> - '�. . _'_____ <br /> AIR CONC�.UNITS-II.Y. FA. 5 <br /> �_.'" " - .._ <br /> _ '_ _ _ <br /> � ___ . . .___'. "_."'. "_'_". _.__�_-r_ __"_�` . <br /> �' NO. T�✓f OF FIXTURE OR ITEM FEE nt�nia[annorv UNi r,: ����. Ln. _^_ ____�y` <br /> �L l:i�I H Tli�iti S � _ OOII GRS__N.�._[A." " _ '_"-"-'_ � <br /> CLO�HF5 ::n5HElt � '"� __L fOfiCEn AIH .`•YSTGr.75 li.T.U. I.IEA. ~-�"-�_-- <br /> , — _--- --- .. . ------- 4L-=-- <br /> pis�� vanSr�Fi:S � <br /> L)IiWKWG FUUNI'Nh$ � - '� - -'-"- -"" �' '----- - �- <br /> FIAOR OfiNtJti � __ SYACf: t4 WALL NEAlCRS - H.T.U. _•___ <br /> UNIT HEATEkS II.T.V. � <br /> KI1C116N tiINKS & DISP_ 2�'� — '—'----'-----�- �-1—'- <br /> ItAH51NK:i � [VnPONnIIVECUOLCnS __'""__4_...__ � <br /> iiooF ni+nir:s f1AW lfAuEliS , / cioniisonvens �� <br /> SHON'kH HATHS VENTIlATtO�I FAN -� ,� <br /> SCHVICF tiINY,$ � fiANGL IIOOU � ��� <br /> ___ ' ---f-! <br /> SU�dPS � tiGWAGE PUh1P "--' -�---�----"- <br /> 1 l�IH IIANUUNG UNIT C � AL . ._.. 1 . _..._y,_� <br /> UN�NALS -"- - "-' . �. . ,�_ <br /> lYN@IILLOtie'1.4 �� . . . . .� . . .. ... _ <br /> I WATL�I HtAfEllti � hlk'CTRIC 7.,� WnTFR HEnTGi1 _ . . . -.'4--- <br /> WASH OA51fd5 ' [ti�' _ _ FAC. OUILT FINEP._ACG W CNIHNEY ' I <br /> — GAS SYSTEM: NO UN OUI'L11S r-_ <br /> LAUNUftY THAYS ._ _._ - - � � - 4'---' <br /> SUIt IbML 5 1�1 �' <br /> _ 1 --' ' --- � � PEIlMIT S 3` _ <br /> '----_—' 1 - '--'-'- " -'- -IOTAI fkE 5 I <br /> �_� � �.�"_ _ <br /> — PEHM TTAL S 111IS PF.IIh4T (I[COMES NUI L �NV VO�U II :lUIIY. �1H CUNbTI1VC <br /> TION AUf11pRIZED IS NOi CON�ILNC([] �YI1111N 1?0 UAYS. O!1 if <br /> --_-_-TOTAL FEE ' CONSTRVCfIpN Ofi 1VO11K I!; 'iU9�'1 NUf.O O1: /�II���C10`EU 1 plt A <br /> WATF:R SLRVICL' iIZL_ OLDG. SUPPI.V $12f: �'f111100 UI' 170 D/��S I�T /�NY IIMF !�1 IC�IIVOIIK Ifl p(�IdL1FNCEU <br /> � 1 Ilf RLII� CERTIFY THM I IIAVC NLAU AND CCNdW[O f1U5 AN <br /> i � - n SFII � .. �r�UA l: HhAH V4NU5titiACK. pLICATION ANU KNO1Y THL S:.Nt 1'O IIL T(iVE ANU COitill-.CT. 11.L <br /> � FT Z�r � `D�T PROVI!:IONS O! I.A1Vi I�NU 4111]INANCF.S GOVEIiYiN(: t1U5 TYPE <br /> Of \901tY, �YIIL BE CObIi'LIFU tVII11 Y:NFT�IER ::N[UFifU ME{ICIN <br /> U::4 %UNL ' LUT AIILA VACANf SI'L � UN NO1. TIIE Gf1/1NTING Df' A {'[fiM111T DOE!: NOl PRC:VME TO <br /> {i (:IVIi AUTIIOf1ilY TO VIOLAfh OH CANCLL f11E PHpV�510NS PF <br /> �� �]/ []YES ❑NO 6 ANV q1nGf1 SiATE O11 IAC.AL I.AW IIlQVL4TiVt:CON'{T��UCTION <br /> Of11NG VCRFUHMANCE Of CONSTfIVC710N , <br /> TYPE OI CONST. UGCUPANCV (iROU�' NU.UL OWi ILING i <br /> � � ` � VNITS <br /> SIZL Of O�l/U0. NO.OF STORIES MAX.000. LOAU X ��� /� <br /> � <br /> �,`�-�-Y� 2' �;< 4��._ .. .�C.'.-�J'..�=.� <br /> Slf��lunCofc TnnclOnOHn��1. nGLNT U.lrr. <br /> �1�11/1:!(INt -�- Y.1$IAII�Nt IIIiL51'Ii1NK1111. �+'�`�'�• <br /> � NI:OUIHfU � f L.�NCIIhCR NUldlitll YIAN CIILI'V, 1 LL <br /> 3 y�� ❑Y[: [}�Pb 1 Ll' -Tl IILCCIPI Nn <br /> SPCCIALCONUITIONSc _ � _ l/-//(�' �V ��'�-�v <br /> -- / FEES ""' VALUATION Ff.E. . <br /> — <br /> - --- --•------ --..._..r- <br /> � _.._"'_._.'_. '_'�_.—.._._�_�.�_ ____ _. . .___.�_L__ <br /> _.....__""_— <br /> '_ .�..'_"'_' ' tlUILDING s��i��•�� _ I_�-T..�DO <br /> I -- I� <br /> --- -- .._�_._.._. __. r--- <br /> SEPA REVIEW CUMPLETE � ❑YES ❑ NO ' 1'lUMI11N(i _- ""_ LI i"— <br /> conlacl plaqninq dopt. M�cnnNirni • I�j�QU <br /> - � <br /> onmi+ i <br /> — - —•---r— <br /> ♦rviv�nw�e�uniuur r�H�celuiu�v u'rovlo ��M�.S:.U�NCI��r � pENALiV SEC. 90]Inl � <br /> .. ..... __..'_ "__ .._._._....1._" <br /> . � � <br /> ____'.__ ___' _ � <br /> . I "_'` TOTAL � � ((:I i . ,�..,.` <br /> . .__._ _'.� ' _ _._____. - _- � <br />