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CONS i RuC i 10N <br />COMBINATION • BUILDING P MECHANICAL <br />PLUMBmIG <br />/ 2�17 <br />OWNEH MAIL AUURLSS <br />llP PHUIJL <br />1 ,�7 = �i Ram 3d7_ <br />SY7o -- 7� <br />N!/--�`� <br />ARCIIIT T UR UEDNL 11 MAILAODfI S <br />PHONZ�i_[7 <br />E LICk NSk NU <br />GENERAL CONT RnCT013 MAILADDRESS <br />PHONE LICENSE No <br />MECHANICAL CONTRACTOR MAIL ADDRESS <br />PHONE LICENSE NO. <br />PLUM a1NG CONTRACTOR MAIL ADDRESS <br />PHONE LICENSE NO. <br />PERMIT CLASS Or WC:I!: <br />' <br />❑CO MUINATION <br />EgaU1LDING ❑PLUMBING ❑MECHANICAL <br />❑NEW <br />[I ADDITION 0AL7Ef1/. TI[1N [XI41•nlll <br />VALUATIONOF WORK <br />❑DEMOLISH <br />❑FLNCE []SIGN ❑'. YI:u MING POOL <br />Cu <br />DESCHIUL WORK <br />pp <br />n/2 frpel r /3ACnnrc Yep f <br />PROPOSED USE <br />OTHERPERMITS ORAPPROVAIS <br />13 REZONE 4:1 SPECIAL USE <br />LLGAL DESCRIPTION OF PROPERTY (SHOW UELOW OR ATTACH <br />FOUR COPILSI <br />SNORLINE <br />12� /11A <br />11LOCY.LlOF1Jll_� <br />.VARIANCE <br />LOT/ <br />SEPA CHECK LIST REQUIRED <br />tl YES <br />=j NO <br />��- <br />JOo ADDRESS <br />- <br />-j 4S5 AU <br />MECHANICAL <br />PLUMPING <br />� <br />TYPE <br />OF ENLHGY <br />❑G ns _ ❑ELEc• <br />EQUIPMENT- FEE_ <br />FEE <br />k <br />— <br />_OF <br />AIR COND. UNITS-II.P. EA. _---_YS_ <br />RLFIRGFRATION UNITS TIP <br />BDit ERS Ii.R EA.-'�"—_----_ <br />MEA. <br />NO. <br />TYPE OF FIXTl1RE Oil ITEM <br />IIAIY 1IIBS <br />�— <br />1 <br />CLOTHES WASHL11 <br />FORCED AIR SYSTEMS R.T.U. <br />SPACE D WALL HEATERS - U.T.U. r <br />011INKING FOUNTAINS <br />FLOOR DRAINS <br />UNIT HEATERS U.T.U. <br />KITI'HEN SINKS R UISP <br />I <br />EVAPORATIVE COOLERS <br />--- '-- —'-•'- ---^ <br />_T- <br />--- '— <br />IIA II SINKS <br />1 <br />IWOF DRAINS RAIN LEADERS <br />I <br />CLOTHES DRYE UtS <br />SH0ICER BATHS <br />VENTILATION FAN <br />SinflVI E SINKS <br />RANGE HOOD I <br />--'- -•� r-^ <br />SUMPS -� SE W'A (iE PUMP <br />_ <br />HANDLING UIVIT C.f.M. <br />- <br />URINALS i <br />._. _AIR ., ._.•.^_--y <br />- � � •��---' 1 <br />%V_AT FIT CLOSETS_ <br />-_ -tYNER <br />__. ....... _^. .. _..._ __ ._..T- <br />4EATER <br />HE ATEIIS - EU.TR :('IO I <br />•-_ _WATER <br />PAC. QUILT FIREPLACE A CHIPANEY 1 <br />WASH BASINS I <br />LAUNDRY TRAYS -� <br />_ _ -.., .. V <br />GAS .SYSTEM:_ NO OP OVTLI IST—~ <br />'SVB TOTAL - <br />--- - 1 <br />----•��-PEIIMIi 5 r <br />—? <br />------ -- TOTAL FLU 1 <br />_ _ <br />— - ^- SUB TOTAL <br />_9�_ <br />T1115 I.F.RMIT IIECOMES NLII 1. AND VOID 11 WORK Ills COISTIVUC <br />PERMIT _ S -_i <br />TION AU TIIORIZFD IS NOI CO`J AIL NC[D NIi 111N 110 DAYS. OR IF <br />TOTAL FEE C� <br />CO NSTHUCTION On WORK I!i SU!U'1'NDEO Oil .VIANDONLO FOR A <br />_ <br />I PERIOD OI' 170 DAYS AT ANY IIML AV TER WORK IS COMMENCLO. <br />WATER SERVICE SI7F. BIDG. SUPPLY SITE_ <br />111[RI:RV CERTIFY THAT I HAVE READ ANT)Cease,+.IN10 THIS AP <br />Ua�l'A n 1 UACK��a HkAN YAHU Sk IUACK <br />PLICATION AND KNOW TIIE SAME TO IIE TRUE ANU COBIU CT. ALL. <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING 1141S TYPEI <br />OF WORK WILL HE COMPLIED WITH W1IETHER SPECIFIED HEREIN <br />T- <br />UUL lUNL WTAIiLA VACANT SITE <br />OR NOT. Till.GRANCING OF A PERMIT DOES NOT PRESUME TO, <br />1i VIOLATI: OR CANCLL THE PROVISIONS OF <br />❑YES ONO <br />GIVE AUTHURITY TO <br />ANY OUTER STATE OR LOCAL LAW I ILGULAT ING CONST RUCTION <br />OR 713E PERFORMANCE OF CONSTRUCTION.I <br />TYPE OF CONST. OCCUPANCY GROUT' NO. OF DWELLING <br />UN175 <br />SIZL OF BLDG. NO. OF S10RIES MAX. OCC. LOAD <br />�— --r <br />N TUI FCONT RACTORO UTII. A[iE NT DATE <br />_ <br />11IiL 7.O[J l: IIASk AIL fJT I IHI !:1'111NK1.L11 asrc AN CH+CI, I IA a*a!•' <br />' RCUUIRLD —� PLAN CHLCK NUMIIG II 1'LAIV CIIL CI; 1 EL <br />❑YL^I ONO <br />I LE IIECEIPT NO <br />SPECIAL CONDITIONS: <br />FEES VALUATION FEE <br />— 1 <br />OUILOING <br />SEPA REVIEW COMPLETE! DYES ❑ NO <br />PLilMnlHo <br />1 <br />contact planninq dapl. <br />MLCIIANICAL i.._ <br />I <br />. <br />OTIIER I <br />1HIICAIIU14µEMIT UVY v1A41 LelU1U YY NfNUYIP U1+11%1�N.I YY <br />PIf N ALTY <br />_ J _ _ _ ----t_--_•^--.. _ <br />TOTAL .��.._ -- <br />