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P R&A6T AFPL(CATi )tN1 <br />BUILDING MECHANICAL <br />PLUMBING <br />OWNER I MAIL AUDIILSS 211' <br />PHONE <br />// <br />.i RI <br />ARCH. TECT OR DESIGNER MAIL AODREaS PI10NL- <br />LICENSENO. <br />GENLRAL CONTRACTOR MAIL ADDRESS PHONE <br />LICENSE NO. <br />ViLCHANICALCONT 1 lACTOR MAIL AD HESS MtNC <br />LICE14SE NO. <br />IIl <br />/1 <br />IlI1 <br />. <br />PLUI,IBING CONTRACTOR MA1LA RCSS PHF7NE <br />LIENS@NO. <br />1 <br />% <br />---- <br />CLASS OF WORT: <br />NUMBER OF STORIES <br />© BUILDING 0 PLUMBING ❑ tort: 11ANICAL ' <br />BASI-IE14T )24 <br />[I NEW ❑ADDITION, ❑ALTERATION <br />®REPAIII <br />VALUATION OF WORK <br />O'' <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING <br />POOL <br />E ~ <br />DESCRIBE CORK <br />1 <br />/ • y�- <br />11HOPUSCO USE - <br />—+ <br />1_I':GAI DESCRIPTION OF PROPCRT ISH01 BELOW ¢¢¢jjj111 ATTACH <br />FOURC�SI �� ,(/ <br />LOT � BLOCI:�OF <br />��t <br />:OB ADDRESS <br />�11if22C <br />PLUMBING <br />MECHANICAL <br />TYPEOFFUEL ROIL ONAS. OLPG. PLOT PLAN <br />IJO. TYPE OF EQUIPMENT <br />Draw plot plan <br />NC. TYPE OF FIXTURE OR ITEf.I <br />AIR COND. UNITS-H.P. EA. <br />]PLOY. side.-- <br />(VATER CLOSET ITDILETI <br />REFRIGERATION UNITS-H.P. EA. <br />on <br />BATHTUB <br />BOI LERS P,BA. <br />LAVATORY IW_ASH BASIN) <br />GAS I°)RED A.C. UNITS -TONNAGE EA. <br />_SIIOl1ER <br />i'ITCHC'.'SINK P.DISP. <br />FORCED AIR SYSTEMS-B.T.U. Id EA. <br />_ <br />WALL IIEATERS-B.T.U. M <br />_DISHWASHER <br />LAUNDRY TRAY <br />UNIT IIEATERS-B.T.U. M <br />CLOTHES)MASHER <br />EVAPORATIVE COOLERS <br />_ <br />_WATER HEATER <br />CLOTHES DRYERS <br />_ URINAL <br />VENTILATION FAN <br />DIiINKI\S FOUNTAIN <br />-- •--' <br />(IANGG HOOD <br />_ FLOOP-SINK OR DRAIN <br />AIR HANDLING UNIT- C.F.M. <br />VACUUM BREAKERS <br />ROOF CRAINS-DAINLEADERS <br />INCIN17RATOR <br />SINK ISERVICE-BAR, ETC.) <br />(]. <br />S;,T'PV 1 Ug ONLY BELOW <br />SIDE YAIIDSEIUACK STREET SETBACK <br />H LAR YARD SETBACK LOF�C�ONNT <br />VUSE <br />ZOIJE LOT AREA <br />VACANT SIT1E�SIG NATUHRACTOR O111 ITH. AGENT DATE �s <br />❑YES QNO I,•EES <br />TYPE OF CONST. OCCUPANCY GROUP <br />NO. OF DWL L LI NG <br />UNITS PLAN CK _ <br />VALUATION <br />BLDG PM T <br />SIZE OF BLDG. NO. OF STORIES <br />MAX. OCC. LOAD MECII PI•I1' <br />PLAN CK 1`10 <br />PPMT <br />FIRE ZONE BASLMLNT <br />VSI'n <br />TOTAL <br />- <br />DKLCHS <br />Rf <br />DYES ❑NO <br />