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- COf�!ST� UCTION
<br /> � P�RMIT �,PPUCATiOh!
<br /> ,
<br /> COMBIi�ATION • 6UILDING • MECHANICI\L • PLUMEiING
<br /> OWNL H MAIL AUUNISi
<br /> � lIN M��UNt
<br /> .� G. " ' . �.. " _" _ I
<br /> ARCH17[CTUR00514NtH . � ' . . '. - . � . .- ` .. _ . " _ �`=j� _ r
<br /> MAIIAUDNE51 YHONE UCENSk NU •. / �"
<br /> GENCqAICONiRACTOH MAILA�DHE55
<br /> PMONE UCENSE NU
<br /> MECNANI�I��CUNTRqCTOq MAI�AOONE55 ,
<br /> PMONE , �—��
<br /> ' '� '' ' ' i 'i i � . "_. . , � .
<br /> CENSE NO �
<br /> •LUMtlINGCONTflACTOR . . . _ . •' .'/ "G T, . �'%•.l /I��F-I' I ..
<br /> MqILALDNE•,.. VMONE LICENSENU.
<br /> / I . �
<br /> YfHMIT . ' . ' CLASS OF WONK /'��--: ' '
<br /> ❑GOMOINATION L ., � .� ` /�, �- / ,1-�� .-� �
<br /> � �^J ,
<br /> " I . -r/� `� 1 . � 9l '�����!-
<br /> ❑OUILDING �PWMOING �MtC1/ANICA� '/ . :: _J:/ � • ' '� ' �: . .�,�/��Ay.rl�I/.�.,✓ ��f � I��/J ,
<br /> ' y-� I
<br /> ❑NEW ❑ADDITION ❑nLiEl!nf14N uiqi•ni11 � _ A -.
<br /> VALUAfIONUF WOHK � �CL.S�j��,(��?I'
<br /> . i', .� �.- �{ _"'""_'_
<br /> S ; .. 'j��/) i_' ��I I ❑DfMOL15M ❑fiNCE ❑SIGN ❑•i�V�A1M�N(iPUpl
<br /> OE �R�OC WORK�i ;���� 1 /' r --
<br /> . • D�?�,r'�� fl`J� i- /I'� • , 1 - / ;t��P�/:'l= il•rTr1
<br /> ,_ � -�?.7/: � � , / - i ' l .: l�l .'l? ((� I-� -- ! . <- ' � .
<br /> YROYOSflOUSE . ' � --" �. . �l �C .- C 1 . �T�
<br /> ;" ,ti�".� �- r_., � � , �, _ „ _ OTHERPERMITS ORAPPROVAIS
<br /> LIGA� UlSCNP TION UF V(iOPERTY ISMOW BELOW ON ATTA�ry�^ � RE ZONE �( SPECIAL USE �
<br /> �OUN C i1k51
<br /> �or 9'� BLOCK__pF , ��• _ � / ^ ' � � �L�ARIANCE � SHORLINE
<br /> � � �, - . ;r �� / ����1� ( / 5 E PA CHECK LIST REQUIRED
<br /> I� YES
<br /> LY N O •
<br /> JOB ADDRk55 't � �
<br /> _ -- -=, �;, ,� , =-,., , D n I ��r�
<br /> -- � � T' i��.� �. , �'�i ��%i �O �MECHANICAL �
<br /> PLUMBING TVYE OF ENEHGV
<br /> ��`�+ ❑ELf.C.
<br /> . NO. TVpEOFE0U1PIdCNT —� FEE
<br /> NO. TYPE OF FI%T�,'PE OF ITE!.1 . AIiiCOND_UNITS_��_P. EA. .-..--'-�y��-- I �
<br /> FEE � qkraiGENniioNu�u�: r�v En.'— _'-T
<br /> _ HAIH iUUti S - -:c' —_ " _ ' ____ "' _'__"__'�___
<br /> ClOir1E5VJ4iHtH � i OOIItR H.o f4. �
<br /> DISH 1'I.\$HEIIS � � FOpCCD AIH SYSTEAI': P.T.U. MEA. -T .
<br /> � . �
<br /> UNIKti1PJG POUYTAIN$ -- '—... _.--
<br /> � �
<br /> FI OUH (711:JiJ5 � $PACE h WAII Nf:AiENS - N.T.U. � _ �—
<br /> KITCHtN 9fJK5 2L DI$P, � VN�T nEnT£P$ H.T.0 �- �
<br /> IlAIlyRJ1,5 T_ EVnvOHniIVECOOLEHS�
<br /> IIOOFDP�Iuti RnINLEADCHS � ttorrqsonvEns -...----��`�T
<br /> SHAP:EH HniHti � �--�—
<br /> SEI.VILE SINK; -. �'ENTI�qTiON f AN �—T
<br /> SUb1V5 - yEtYAGE PUMP - RANGE r�000 �
<br /> ___.__"_
<br /> � U�11Nl�L$ � MN MANDUNG VNIT �,�.I�1,
<br /> .�__�_�_.___—"...� .... ..._� _
<br /> -r �vnrevctos[is — ,� , , � _ �
<br /> :VAIE� H6ATEIly �� ELECTRIC ^� W4TER N[ATER ^���
<br /> WASM OASINS - , .�� �� FAC BVILT F:qEPLACE R GUh1NEY -r�_ j
<br /> �� � �
<br /> LAUNDRV 711qyS (:A5. 5�'STEM: NO OP OVTU.IS � �T--
<br /> _ ' �----- .. ..:;�n rciin� s1��._
<br /> ' '�--' -"- venniir�-g.-___.__._�_
<br /> -- � _�
<br /> suoroiai • .� ; .� - ' TOT4LfEE 5 — �
<br /> VEfih11T 5 .� - Tllt.^. PF.PldIT.UFC061E5 NUI L I1N1) VOIU il WUIIY.�IIH lUYSTHUC
<br /> TOTAL FEF � �� T�nN nV�uOqilCCl 6 NOI fp`AMINC[D 1VrtqiN 1:0 Uav., pq �F
<br /> CONSTIIUCfIpe� pq WOfIF 1:: .•iU1U�fNDED O11 Ap�NDO\[U �OR A
<br /> NAfEfi SFRVICE SIIF. Bl�f SUPPLV SIZE ����oo oc I:0 DAY$ AT /�NY rini� 41TLHK•O�K i!:Cf+•,i•dENCEU.
<br /> �' �� � �. M1 S HL .. �TUAIA HtAHYANU5Ft0ACG� I IICPtIiv CEf1TIFY 111AT I 11/�VF. HEAU AND CVA611N[O T1�154P
<br /> li e /�i�f�j/-� ���". ,. � � J r PUCl1TipY 4Np KNOA'! TUE 5.A�•E T(l l�h THUE ANU fOI:H!ff. ALL
<br /> �J• VROVIS�pNS OF �AY;S ANp OfIpINANCES GOVE�N�NG tiu5 TVnEi
<br /> VS�ZUNk'•.:�� LOl AIILA / � L__ ^ OF WOIIK W�LL OE CCtdPUEU WIfH WNEii�Eft ::P[QFIlO N[i1EINl
<br /> VACANf �11L 011 NOT T�If GPI�NTING OF A PERMIT pplS YOT PPESUME t01
<br /> � � 4�VE AUT1iOq1TY f0 V�OIAfk UN CANChL TIIE NR(IViSIONS OF
<br /> ❑YES ONO , qNY OTMER STATE OR LOCA� �.A\y �IC(iULANN4 CON::TI�UCTION
<br /> 7YPE UF CONST. UCCVYANCV GROUP NO.Of UWELIIry(i aR�`�k PERfOHMnNCC Of CONSf11UCTION.
<br /> . —�_ i UNITS - —. ♦
<br /> SIZ[ OF pIOG. NO.OF STORIES MA%.OCQ LOAD ` \ j {r
<br /> �� X� � ' / �- � _/ \,
<br /> �-r«'�., ! r ;'C�-. � .� �
<br /> IINIZON!—� IIA.^.kMLNi IIIIL51'IiiNKI(115 SIGNI1tUREOPCONTqACTOROR�VTII �(iFNT pdTE�
<br /> flOYCiEI) QNO ��l.1NCItl� NUM11l11 %
<br /> � / � �� (2."�Mp;an � ,Mu.c
<br /> V � /5 � rtc�, • G,u nec¢irT Nn.
<br /> 5�6GA� �ONDIilONS: �
<br /> .!. � _.. /6 � ��/�,�� ,./
<br /> _ FEES VALUATION __FEE q 2� �K
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<br /> __""' OWLDINC f-�.-�1 ___'
<br /> _ __ � "' ' _._�_ .:�d___.—"� _ _"r'_'
<br /> SEPA REVIEW CORSPLETE � ❑YES ❑ NO � P���MIIIN�: �
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<br /> conlotl Planninq dopf. McainNicni'--••'- , i � ..
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<br /> ot�¢n I
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<br /> wuu�wvn�un�un IIAN)I.MIl4lU�� --_ A/f11O1�O111W/I.1�1-Y� � aENAl7Y SEC.JO]OI 1
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<br /> _._____ _______'_ ____.__._ I
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