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- GONST'RUCTION <br /> - ' PERMIT APPLICATIUN <br /> COMBINATION • BUILDING • MECNANICAL • PLUMBING <br /> OWNtH MAILAOUHt55 Zlp VHUWG <br /> _� <br /> �� . , r� ���,in .�„-•.., i L:�.( ^�i � _ . �i .�> � � �7 G�. 7, � o � <br /> �L1.�� . : . ir,:l�. e ± �.E, , o d_2Ti� �i.: / r . er���f /C ���.+� c�_JJc� -��� <br /> ARCl/ITEC7 UH UESI(iNEH MAIL ADONE55 � PHONE IICENSE NU <br /> GfNCRALCONTRACTOH MAILA��HESS PHDNE UCENSENO. <br /> '�-.�i' �it�� i-� `� �1 C!'iL�7= i�' s'��/�' �9/L -�L� .. ��` `"� ' �+ <br /> MECHANICAL CONTRACTOFi MAIL ADDRE55 � VHONE LICENSE NO. <br /> Y _ �J� <br /> —i.t ri:Ji�iLi� ��`'.� h'_ ��)i'2%'�/I;c'�`'./' ' <br /> PWMUINGCONTHA�70R MAILADORE55` PNONE , UCENSENO. � <br /> _�, ' � �"�CCii�.'�li'c: <br /> VERMIT ( , CLASSOF WORK • �-- � <br /> �COMBINATION , / � <br /> Q�UILOING �PLUMDING �MECNANICAL �/ � <br /> 1{JN�w ❑nODIT1UN ❑ALTEfIl�f�UN ❑H(I�M{I - <br /> _'_.... .....__ __ . '_._.. ..'._""_ <br /> VAWATION OF WORK � <br /> S ❑OEMOLISH ❑F(NCE ❑$IGN ❑':\VI�IMINfi 1•(101. <br /> DESCfiIOG WORK ' <br /> \ , �I/ <br /> vqoro5[D uSEV OTH ER PERMITS OR APPROVAIS <br /> "� � ��'� '�'�— j� REZONE � SPECIAL USE <br /> �LGAL l)h5C1UPTIUN OF PROPEHTY ISNOW BEIOW OR ATTACN � <br /> FOUq COPIl51 ` <br /> 1-04+�.s-RlOGKa�aOF�' ��'��.�' �'�. �''c7 ,i �CVARIANCE L� SHORLINE . � <br /> SE PA C;7ECK UST REQUIRED <br /> � ��� .�..c� � �Yi l� O� '�'r��^.� /;�,�,� � Y E S <br /> '� � i 1 � NO <br /> -'�(i C C�/ '�,�.r/C I'i '�%�/�.,.�., „� ;. <br /> JOO AOORESS � <br /> \ l ,� . � � �MECHANICAL <br /> PLUMBING . TYYE OF GNEHGv <br /> ❑.n5 ❑FLP.C. <br /> — "_'.. . _.. . ."__ <br /> . NO. TYPECFE�UIPMENT � `_FEE - <br /> _'_ '_'—_'_"_ .... .....�'___ '." <br /> AIRI'OND.UNI75-/I.P. EA. S I <br /> _._ '."'_'. "'_"'_ ._'_'. ..'__—.-_ ._'._T_�. <br /> NO. TVPE OF FIXTURE OR ITHtd FEE qEfRl(iERATION VNifS IIY. [A. __� <br /> I4A7H IUUti S O011lfl HP. EA.�- "- "'—'�""---"'-^—�- � . <br /> _ ciomes �;�ns��er: � — -- -- - — --!--�-- <br /> UISH PJ.�SIIENti � � _ FOfiCED AIR SYSTEMS D.T_V_MEA. <br /> _ _L.___ <br /> UHINt:R.G FpUNTA1NS � +�:_s_ � '._' _ � 1 <br /> Fl OOH DNAIN$ � SNACE b WALL M[ATlf1 �II.T.U. � __L <br /> KI1l:��EN tiINKS P. f715P. i UNIT 11FMER B T.LL ___ I '. <br /> IIAR SINKS � BVAPOHMIVE COOLEHS —T— <br /> __�_'""_ L <br /> l HOUF UHt.INS RAIN L[l�UHiS � L CLUT11[5 URVlR$ -...-__-- ' � . � � <br /> I SHOP:FFY HATHS �_ V[NTILATION FAN ' ��T_ <br /> SEHVICE SI1:K5 � qnNGE NOOD � � <br /> SUMPti �� SEWAGE PUMP --� —�--� ---'- -- T � <br /> - AIRIIAN�LINOUNIT C.�.61. � <br /> URINALS � '_' ._'_'__�._'_.... .... ...' " _.' �"_.___. <br /> '% WA1FIiClOti[TS ' � � <br /> . . . . ... ....__._. ._.. ._. . _ _ . ._ . . _ .""T._ <br /> _ WnTEi7i�F.ATEHti_ ELECIRIC � Wn7EHHEAT[q. . _ ... ...�__� <br /> WA:iH DA51Nti - � FAG. BVIIT �IREPLAC[ 8 CHIAWEv I <br /> LAUNUFV TIIAVti - GAS. SYSTEM: NO OP OUTL115 � � T� <br /> ' __ " '_" L <br /> _ SU11 TOMI 5 I ( . F . <br /> ' 1 _" _ '___'. .._..pEfiMlT _5 '_"'"'__j'___ <br /> . _ _'_"__'_"' '__"_'..__._.__" ".__ <br /> � 70Tnl. fkE' S 1 � I <br /> __ _ SUOTOTAL �1— . ."_'. .. _ .. . . _ . . . ""___'_ ' <br /> PEllhilT S 1 11115 Pf 1161IT OECOM6$ NU11 nNf)�VOIU 11 WUIIY. t1H C.UNiiHVC <br /> --TOTAL FEE C —� TION AV�IIpRIZC.0 1; NO1 Cp`d41LNC[UNITIUN L'OOAY':. OR IF <br /> CONSTIIUCTIUN O(� \YO(IK 1:: SU::�'I:NpCO O11 Aftl�NOONLO �Oil A <br /> WATF.R SERVICE SIZF. E3LDG. SUP�LV $IZf. NCI110U OL 1:0 DAYS AT /�NV fIMF A1 iCIt1VO11K C:CP:'�4�FNCFU. <br /> �• c . �6 UA K NLAH VAltUSktUACY., I IICRLIIV CLfiTIFY �IIAI 1 nAVE NLAU ANI) !:�(AA11NI0 f1115 AP� <br /> � PUC4i1C�N ANU�KNOIV TNf ;.1�IE TO Ul TRUE �WO COHIIFTT. 1LL <br /> ' � - PqflVl•.{IONS UF�LAIVS I�NU 011DiNAhCF.S G4VE�tMNl: T�U$ �VPE <br /> � ' OP WDIIK 1YIU.j`HE COMPUEO WIIH W1IETHEi1 ::Vf:CIFIfU ME�EIN <br /> U:iL 7UNt � �Ul A11LA VACANT::146 �— OII NOT. THF RRAN':WG f)f A VERM1IIT D S NOT PNESI�ME i0 <br /> �-'- �� - � � D�ES ❑NO I �'�VE AUTI�Ufi1TY TO VIOLAf! OH C .�TIIE i'RUVISIDN$ OF <br /> l'�_ . . ANv OTIICR STATE OR LOCAI 1.4\V P C 11TINti CON::THUCTION <br /> . TYVf OF CONST. UCCUMANCY GFOUY NU.Of UWF�LING ON iMt PUIFORMANCE Of CONS I , <br /> UNITti j� � <br /> • SIZ!OF ULDC. NO. OF STORICS MA%,p��. I,OnD � -/ <br /> x I� � <br /> — SIGN P .�COP FACT Ii HAVTI�.A( C:NT f 4 ' <br /> fIHL '1[)NF�� IIASlMLNi �INL".i'111NK1.1.11:: <br /> � . PfOUINlU VL:.N GMLCA NUM❑ N Yl fV CIILCA FL <br /> . ❑YES ONO np e� ��_� � ttECEirrv�� � - <br /> S�LCIAL CONDITIONS: /^ /,,/ <br /> "" _ / V _7�7.� 6g . _.I 3!9/s . <br /> FEES � VALUATION FF.E � <br /> _ _ �_'_ , ' _ '_...'_7'__ <br /> __�___'—�__' I <br /> ""'...__—_ _ .__�'_L"' <br /> .�_._.___ / 1 I <br /> I OUILDING S� [ OD � 1 <br /> ... . ___ - ..l.j..._._� _. .__.._..r_ ._. <br /> � PlUMI11N(i <br /> SEPA REVIEW COMPLETE � ❑YES ❑ NO _._ . �__...__ ' � : � <br /> conlact planninq dept. M�ciinNicni • ; i, � <br /> �--. .. <br /> on�cn � <br /> i <br /> --T— <br /> �/�IICAl1UM����ry�Ub1 /U1M�LMI�R\UYV. YfdOV10 O�IYY PENAITY SEC. 7071�1 � <br /> � � � ' ` ._ . .._�..�_ . _... �. �.�._..j . <br /> TOTAL � - �, I �.. <br /> " _ _ _ . . ' _"..__ __ __' _.__—___ _ � I <br /> -�._ <br />