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C�1 �9 � <br />O�lx <br />C H <br />9 H q� <br />i <br />y i-�i <br />�H7�d <br />41 `x1 h7 <br />V1 H <br />�O� <br />H <br />ON <br />H�g <br />(�] Y (] <br />zyy� <br />r t-i y <br />� <br />gd� <br />� � ts1 <br />xyw <br />HOfn <br />I� <br />1 <br />I'�� <br />w� <br />r.PPL1�:A�lON FO�. <br />'"° `'°,°,°"` C O N ST R U CT I O N <br />��.. �F <br />evere�:t PERMIT <br />BUILDING DEPAFTM11ENT <br />259�88�0 TU BE COMPLETED IN INK - PLEASE PRINT <br />❑ DEMOLITION ❑ COh1BINATION ❑ [3UILDING \��'IECHANICAL <br />❑ PLUMBING _ <br />�,v� <br />L��"��' �I `t�LLi- <br />r�ercn <br />� <br />❑ SIGN <br />..�.rp1LC�in.C,t'.�GylN <br />r.IEILAO�fII'ati � �."• ••. •.....••- <br />�;n\ VUONL ��CLYGl.a <br />..'.Li���t�sN�n<;�J� MULapO�:iSti u <br />❑�'NCW �� ADDITION �-AITEFATION ❑ REPAIfi ❑ �EMOLIIIOt� ❑ WOODSTOVE'FRPL.INSERT ❑ F3UILDING PELOCATIOtI <br />.n�'y4*iONOr�H�n. COStO�•�aiC i4L:.rLCSL.Itne, <br />1 I I.n i. %1) <br />NOHN <br />1LG41 <br />� ��� <br />PLUMBING <br />TYPE OF FqlTU <br />WqTEP CLOSET ITOILET� <br />BATHTUB <br />�qyATORY I�VASH pASiN� <br />SMOWER <br />KITCNEN SWK ,l pISP <br />DISMWASNER <br />IAUNDRVTRAV <br />CIOTr+ES SvaSHER <br />URINAL <br />� _ F100� OAaIN <br />II 1 _' OACKFLOIV PREVENTEAS <br />I FOOF �RAINS —�AINLEAOERS <br />—�SINH �SERVICE —BAR. ETG 1 <br />.uUrA SE�OaCr <br />us� ronE <br />I�PEOI COYSt <br />.,:e o� u;ne <br />fIRE SPRINN <br />SUBTOTAI <br />PERMIT <br />TOTa! FEE <br />RE4R CE�PICM <br />OCCUPANCY <br />I NER[BY CERTIFY THAT I HAVE i7EAD AND EXAMINED THIS AP� <br />PLICAIIONANDKNOIViHESAMETOBETRUEANDCORRECI NLL <br />nnac��rouncowts� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br />OF \VORK WILL BE COMPLET[D 6VITH WHETHEP SPECIFIED HERE� <br />IN OF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUM[ TO <br />GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS Of <br />ANV OTHflR STqTE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR Tf1E PEfiF�JRMANCE OF CONSTRUCTION. <br />SI�NAIUFEOICO'rtP<GfOP09?Ui1'Cql2[paGCNi DA1F <br />I <br />�X ; �;k;ti���, `dr ��, 1 `� zi << <br />:.rW..e�nsanEn�,� i,v•.� ' <br />MECHANICAL <br />ITEM FEE NO. TVPE OF EOUIPMENT <br />A�G — A�HNOLG UNITS — M P <br />�EFFIGEPATION UNITS —!i P EA <br />DOILEPS—OTU�MP I(''/� <br />GASFIREDaC UPIITS—OTU <br />FORCE� ��R SvSTEAlS — B T U M EA <br />\VALL MEATERS — [3 1 U M <br />uNir He�rEns — o r u M1� <br />EVAPORaT1YF COOLERS <br />CLOTHESOAYERS <br />VENTILATIpN FAN <br />qnNGEH000 <br />WATEF MEATEF <br />WO00 STOVE <br />� METAL FlPEPLACE 8 CHIMNEV <br />FIFEPI. CE INSERT <br />MEAT PUUP <br />GA$ PIPING <br />E%MAl15T FAN <br />� �'i t ��5 Lr�ECnCO Ov <br />3 <br />� <br />E <br />VAUOi SItC <br />❑vC5 =N0 <br />40 OF Ow(LLINi: ��NitS <br />StIB TOTAL <br />PERMIT <br />TOTAL FEE <br />r'�aN CnECK NUMBER I FEE <br />fEES <br />BUIl01NG S <br />PLUMOING <br />MECNANICAL <br />OTHER <br />tiTAiE �UILDING SURCHARG@ <br />$TAT[ENERGYSURCHARGE <br />PU�LIC \YORhS <br />TOTAL <br />FEE <br />PECEIPT NO <br />PROPF.RTV OWN[RS ARE RLSPONSI�LE FOR DETER�dINING aLL <br />PPOPLRTY LI"E LOCATIONS AND RELATED EASEI.IENTS <br />V <br />