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BUILDING MECHANICAL PLUMBING <br />OWNLR MAIL AUORLSS ZIP I•HUNE <br />75 � AC1 P 116/7 �jc ,� 1 <br />ARCHITECT OR DLSI Lli MAIL <br />AUDIR:SS PHONE LICENSE NO. <br />GENERAL CONTRACTOR MAIL ADDRESS PRONE LICENSE NO. <br />S/N Nvrrt _ `,te✓�/ye+�% <br />� <br />/3a5" .y.Qdiso.t S 2 S �?-oI-D.-cv-�iw-ic3�+z <br />MECHANICALCONTRACTOR MAIL ADDRESS PHONE LICENS_ I.O. <br />PLUMBING CONTRACTOR MAIL ADDRESS QHONE LICENSE NO. <br />CLASS OF WORK <br />NUMBER OF STORIES_ <br />[I BUILDING ❑ PLUMBING []MCC HANICAL <br />BASMENT <br />❑NEW ❑ADDITION• []ALTERATION ®REPAIR <br />VALUATION OF WORK <br />11 <br />/+ 0100 <br />❑DEIAOLISH []FENCE ❑SIGN nSV:R.IMING POOL <br />S _Ira <br />DESCHFBE ', RK <br />- <br />%STY/ L New C e/�ien.i 13 Lock-- <br />PRUPOSED USE <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH � ----�--�� <br />FOUR COPIES, ,�• <br />LOTS'" BLOCK.3.)i_OF f- VGf 4Yf I�l�✓ V _ <br />JOD ADDRESS <br />% <br />PLUMBING <br />MECHANICAL <br />T•vPE OF FUEL ROIL ❑c T. jJLPG. PLOT PLAN <br />I10. TYPE OF FIXTURE OR ITEIA <br />NO. TYPE Or EOUIPMENT <br />Draw plot p1.E111 <br />TWAT EA CLOSET (TOILET) <br />AIR COND. UNITS-H.P. CA. <br />R- on back side. <br />EFRIGERATION UNITS-H.P. EA. <br />OATHTV5 <br />LAVA-. CRY V (WASH BASIN) <br />BOILERS-H.P. EA. <br />S HOV-OI•. <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />KITC/,S', SINK ✓Z DISP. <br />_ _ <br />FORCCO AIR SYSTEMS-B.T.U. M EA. ' <br />DISHWASHER <br />WALL HEATERS-B.T.U. M <br />LAUNO<Y TRAY <br />UNIT HEATERS-A.T.U. M <br />CLOVES WASHER <br />EVAPORATIVE COOLEHS <br />WATER ~EATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRIXKI`.G FOUNTAIN <br />FLOD;-SI\K OR DRAIN <br />RANGE HOOD ' <br />VACUV.• BREAKERS <br />AIR HANDLING UNIT- C.F.M. <br />RD(1F CPAINS-RAINLEAOERS <br />INCINERATOR <br />SINK (SERVICE -BAR. LTC.) <br />CTIPV 7GF ONLY BELOW <br />SIDE YAHOSETSACnSA MEET <br />HEAR YA[IDSETBACN /% <br />USE ZONE VACANT'SITE SIGNATURE Of -CV NTIIACTOIIOR AUTM. AGENT DAIr.❑YES <br />❑NO FEES <br />TYPE OF CONST.P NO. OF DWELLINGUNITS PLAN CK VALUATION <br />IILDG PMTsize <br />ur- BwG, MAX. OCC. LOAD MECII P -IT PLAN CIC NO <br />PLBG PP1TFIHL <br />ZONE fl(1C 51`IIINK LL'HS <br />RF_OUIRED TOTAL <br />UYES nNO <br />