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■1 <br />� • � �� � ��ERMIT APPLICATION �� � .` �,��� - � �� ;: <br />.._... . . � . � _. _...__... .. ---- � -- - r � <br />. .- .. . : , .��r <br />� ' BUILDING MECHAMCAI: PLUMBING . „�a.�%;.� ;s � <br />- � <br />O'. �'kN—� . _ MAIL AUUNh55 ZIP PMUNE i. <br />� ;:5 T /'i� l ��'=.�`e: %- � . ', . . ; <br />AHf',MITiFTOHOESIGNEfl , MAILADORE55 PHONE . LICENSENO. � <br />=�:�ic� a� �;� �;>r�� ,-_;_,,� � <br />GENEH�AL pNiRAGTOR MALLADDRE55 _"/ �y' ►NONC- � LICENSE NO. �. <br />n._ � <br />%! ! i% Y� n �� i S -i: (i�; ;; '��; � �-; ; f '!-. >�.v�;,.—,o,% . <br />MECHANICALCONTRACTOR . MAIL ADOHESS � • PHONE • LICENSE NO. ' <br />�LUMBINGCDNiRACTOR _ MMLAODRE55 � � �HONE LICENSENO. � <br />• � ' GLASSOFIYORK . ' - i <br />NUMBER OF STORIES ❑ BUILDING ❑ PLUMBIN6 � MECHANICAL • . <br />BAShL•;:�T �� ❑ADOITION, ❑ALTEMTION ❑REPAiR I <br />VALUAl10NCF /WORK . , i <br />' s /!.�/, �`� . ��!) ❑DEMOL�SH ❑FENCE ❑SIGN QSWIMMING POOI � <br />'7 i <br />GESCR� yfOXK ��� � . . ' ' , <br />�/�/r' % 7�l��n%' C,'- H/-�%V //L� �� �'�� � � � <br />i <br />PROvO � � ' -� <br />i <br />� \ <br />, �Y , < < ��� � �c�,l;Z���'-1 - . . , <br />LEGAL OESL��7TION OF PROPERTY (SIiOIV BELO�Y OR ATTACH � <br />� FOURCOPIE51 `� L� � L� ' I� — �j� ` , • . <br />. LOT BLOCK—OF � � : <br />� / / "—� <br />: i l—� l�Y 1. � ' •C � �_ • � �/Ll� � ' //i�/ /" /(: � �J/ .. . i <br />, . . . . .. . . ' • ' I <br />� JOB ADDRFSS ' . . . <br />. � i � �C9 /�v�'i2 i� � • � � ' � <br />PLUMBINC MECHANICAL • � j <br />� � _ TYPEOFPUCL �OIL �NAT. �LPG. PLOT PLAN . � <br />GAS � <br />N0. TYPE OF FIXTUFE OR ITEh7 NO. TY.PE QF EQUIPM17EN7 Draw plot plan <br />WATE�::OSET (TOILETI n�� COND. UNITS-H.P. EA. <br />BATNTI;3 RE�HIGEHATIOY UNITS-Ii.P. EA. OIi YiaCIC $1C�E. <br />. LAVAi[BYgyq5MBA51N) 8011ER5-H.1•.EA. � ' : � <br />5410\'.=R CI:S FIREO AJ1 UNITS-TONNAGE EA. , . <br />KITCMS•: SINK d �ISP. FORCEO AIR SYSTEIdS-B.T.U.' ht EA. ' <br />DISMl1A>w�q 1YALL HEATERS-O.T.U. M � � � <br />� LAUNDCY TqqY UNIT HEATERS-O.T.U. M <br />_ CLOT�S��'nSNER EVMOfiATWBCOOlERS ' � <br />IYATEnt'ATER CLOTHESDRYERS ' � . � � ' <br />URIKAI . • - . <br />DRII:KI\3FpUNTA1N VENTILATIONFAN ' , , <br />FLOOF-51\K OR ORAIN RANGE HOOD ... . <br />VACUI'Y iREA1:ER5 AI:1 HnNULING UNIT- C.F.M. � � ' <br />� . ROOF C=aINS-PAINLCAOERS IN^I�ERATOR � � , � <br />51NK ISEiVICE-f1AA, ETC.1 . . <br />r <br />' w' ��� ONT�Y BEL04T • �,: _: •• <br />l SIDEYAROSe78ALK STflEETSETUACK REARYAR�SETBACK � � �� ^ V' � � ' <br />% � <br />_ . . � . �`.��,� � . . �;l,,� -� : <br />. USE2UNE LpTARE/1 VACANTLITE SIGNATUHEOFCON�ITAL`TOPORAUTH.AGENT DATE <br />� . OYES ❑NO ' rL,•L$ . � <br />� TYPE OF COAii. . OCCUPANCY GROUP NO.OP OWL'LLINC // /-/.,e� _ <br />ur+�Ts PLAN CK VALUATION Y�i <br />_ BLDG PMT� <br />. 512E OF BLDG NO.OF STOflIES MAX, OCG LOAD MPyCH PMT PLAN CK NO � <br />_ PLSG PMT ' <br />IflEZOiVE 6A5'M N 111lSP111NKL�R - • I <br />• qeouineo TOTAL �y-2 __ . ' <br />� ❑YES ❑NO ' , <br />