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— CONSTRUCTION <br />r ERMIT APPLICATION <br />��/��r/>> <br />�Ci�' <br />fOMBINATION • BUILDING • MECHANICAL • PIUMBING <br />. _ uo�� ,..,....�... <br />c; <br />��`. �"1i . sL�s,- � <br />❑COMBIN4TIGN «AS, <br />- UILDING �P�UMBING �MECHANICq� <br />VAlUAT10N OF WORK <br />S <br />OESCRI�EWORK ' <br />����t �:«• f ���,��.vG,�r- 5�,�1 <br />vAovoseo use . <br />ItGAL UlSCFIPTI(;q pF YqOPERTY ISHOW BELpW pq <br />�OUR COP1E51 <br />LOT BLOCK�OF ���'�Lo.�' .(>%2 <br />L a t 3� �Sr- �t.� �'7l , t ? C• <br />PLUMBlNG <br />PE <br />� �.�_�� C�-�v�; <br />�' -C ;.�°/ <br />5jj <br />�EW ❑AODITIUN ❑ALTEHnlIUN ❑111.PN11 <br />❑OEMOLISH ❑FEN�E ❑SIGN ❑':1VIMMINfi 1•(�p� <br />A <br />� <br />�oa,i �-c �-�`c, /� �y <br />)THER pERMITS OR APPROVAIS <br />� RE ZONE �j SPECIAL USE <br />�LVARIANCE � SF'.ORLINE <br />SEPA CHECK lIST REQUIRED <br />L'�' YES <br />I� NO <br />MECHANICAL <br />TYPE OF ENEFGY <br />Ur.nS ❑ELEC. <br />. NO. TYPE OF EOUIP�AENT --�- FEE <br />AIR COND. VN1T5- . _ .-..-'-'-j'-' - <br />H.V. tA. S I <br />RFFRIGFRATIp.y VNI( : 11 V. CA. _- -"- <br />OOILER$ H.V EA. _ "' ""_'_.'__.__�__ ; <br />FQACEO AIH SVSiEM'� O.T.V. MEA. �-T <br />__' ____"—. _. ___ � <br />_._' <br />SPA�E b W _A�L NEATENS � H.T.U. ��—T��- <br />� <br />UNITIIEATERS H.T,'� � � <br />EVn�OHATIV@COOlfHS __ ._�T <br />CL0T11E5OqvEPS � � � <br />VENTIIATION FAN ___ _ i T <br />- _ _ • _' "-..,, , i � <br />U(IIYA.LS � AIN 11qNOLWG UNIT C.I.M. 1 <br />LYAI[qClOti[TS ' _".'_ .. ... . ...... ."'._._'�'_"-� � <br />WAiE(1 HFATE115 - ELECTRIC � N'nTEH HEATER � � � ���� ���-��T <br />WASM OASINS ' � FAC. BUIIT FIREPLACE !4 CNIrdNEv <br />LAUNDqYTHAVS ' - � � <br />__ GAS. SYS7 _EM: NO OP OV T11.15'-'...._�--"'T^ <br />� ._'._" ..... . � <br />_ � -_�" "" SUO TO �AL._St. � �_' <br />-- � _ '__ PEfiM1i � 5 T' <br />$UD TOTAL � ' T[>TAI. FtE 5 � <br />PERh71T 5 TI115 PF.fo.iIT:OCCOMES NUI L 11Np VqIU II WU1t1: f�N l7p`iSTRUC <br />- TOTA� FEE � T�ON AUi110lIIZ[D IS NOT OULIMLNCCp 1Y�tu�N 170 U\v5, pq ip <br />NAT[q SF.RVICE Si2E . �°YST����cnoa oa wo4K i:: SUt:�`F'raOEO nn nnnNDOVEu �on n <br />BLOG SUPPLY S12E N[�IOU OF 170 DAYS nT �Nv tihi6 AF TEfi WOfIK q: C[�`d�. EN�EU. <br />i n Sc . � � i� �TJACA HhAN YAHU5ti0qCR� 1 11[REllv CEfiTIFY TIIAT I IIAVF: HEAU AND CYA6�INlf/ flll: AP <br />/J FLICATIp�; AND ANOW THE SnA�E TO IIL THUF. ANII C(l1:HfCf. All <br />"���_ '/ ( GROVISIONS OF �,�WS ANU OfiDINANCE$ GC)VEfI'JWG iH�S TYPE <br />U,:L IUNL �p7 qq�A V^�^Ni���1T_� OF 1VONK WILL BE COS'P��EU N'Itll WMET��FR SV[CIFI� p HER:In' <br />1 OF NOi, T�iE GRqN7WG f)F A pERMIT ppES NpT PFESV4�E 70 <br />�'��-1 OYES Q,fjp �'�VE A�;TIIORITY TO VIOLAfE pfi CANClI TIIE MR(IVIyipNS OF <br />, ANY OTNER S1ATE Ofl �OCAL I.4W 11lGU�AT�Nt: (:qN\t11UCTiON <br />TVVE UF CONST. UCCUPANCV GROW' NU.OF pyyg���ryp OR TMF.�PEfiFONMANCE O� CONSTHUCTIqN. <br />V..._ � '}- ( UNITS ..'_'_ :. \ � I <br />I_ '_ I <br />512E OF OLOG. NO.OF STORIES MA%. 000. LOAO I � � � f <br />1,fnX-48 — _ � _ --- X_�` c'_Y''r�`c;C.�'�°.O �o�7_�I-�-, <br />� <br />SPLCIAI [pl�OITIONS: <br />- Tc� ,�� c i <br />i ./'! •� <br />.(._. L, L... <br />—��.z� l.''-l_1l11� <br />--- nmun�tu <br />❑YE.", ❑NO <br />9 <br />SEPA�REVIEW COMPLETE � ❑YES ❑ Np <br />confact planninq dep1, <br />WIICAIIUNFlUfI1UY� �IAMSINII(1U�Y - <br />., uf�0�'10 UnLL:U�K1�Y I <br />� � — _���� "� . _ � <br />� <br />-__`"' '_'_ <br />UUILDINC <br />YLUMp�NIi <br />MLCIIANILA� <br />OTUCR <br />PFNAl7Y <br />TOTAI <br />......,cr. vIAN CIILCA 1 �! <br />It[ nECEi�r ��n. <br />� —� �—� ,.c� v <br />5 _ VALUATTON _ FEE <br />--'7 ' +-- <br />_ � � <br />s I. � t_:��`_�— C�. �� <br />_- �-- - . _.i.. �'� <br />I <br />. � <br />• - 1-.�... <br />. ' <br />� <br />SEC_JO] I_I- . _.. I__�-._.. <br />� <br />