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,nr C<<:i,:n����� � <br /> CON5TRUCTION evei•ett � <br /> � QTV OP � <br /> � eve rett P�RMIT <br /> I :i1Y 114L1 ?S�M1�.95 <br /> l\'INLI1 '�i4C111'Iliillll <br /> G`.:�1 <br /> ',�, ;" `°�"'°�°' BUILDING MECHANICAL PLUML,i\G <br /> ntuum�v[mt <br /> OWNER MAIL l�IJpHE55 ZIP PHONC <br /> s v �*'-•-. .n.�„xI '3�7 "_ '. �:�^Cs3 2�'�• t°r�1-7G <br /> ANCHITECT OF L�SIGN@R MAIL ADDRE55 PYONE LICENSE NO. <br /> GENERAL CONTRACTOR MAIL ADORE55 PHONE LIC[NSE NO. <br /> J`�f�.� <br /> MECHANICALCONTRACTOF MAIL AOOtiE55 PHONE LICEN�E NO. <br /> PWMBINGCONTFl�CTOti MAILADDRE55 PHONE LICENSENO. � <br /> W <br /> m <br /> P[FMIT CLASSOFWOHK � <br /> x z <br /> �}6UII.DING ❑ PLUM�ING �MECH/�NICAL � <br /> ❑NEW ❑ADDITION ❑ALT[RATION ❑RBPAIfi � <br /> VALUIITIONOf W�^OiiMK �"" � <br /> 5 �fy�yy ❑DEMOLISN Wr[NCE ❑SIGN ❑SWIMMING POOL a <br /> OESCFIBE WORK <br /> ec�;,.,;r.., ,.r��c�-� ,r ���� M,, = t� ,r�x; $04 <br /> PIiOPOSED VSE MECHANICAL <br /> L[GA�DF.SCRIPTIONOFPROPERTY �SHOWAEIOIVOH /UTACH TVPIOI' FU[L �011 ❑GAS ❑LPG. �r_EC. <br /> FOUR COP�E51 <br /> i or OLOCK—OP_ ��0. TYPE OF EQUIPMENT FEE <br /> Alfi COND. UNITS-��.�. EA. 5 I <br /> RI:FRIGERATION UNITS-H.P. EA. <br /> . — �OILERS H.P. EA. I <br /> GAS FIP[D A.C. UNITS-TONNAGE EA. <br /> FORCED Alfi SVST[MS-B.T.U. M EA. 1 <br /> JOD AODRE55 �� s��f Tn 1NALL HL�IT[RS-�.T.U. M i_ <br /> �YA/ YiZ"I4 M-M �UNii HEATEPS-�.T.U. M I <br /> � [VAPUP��tIVE COOLfRS <br /> PLUMBING ��Lon�es or�v�r�s i <br /> — �VENTILnTION FAN <br /> PnNGEH000 I <br /> NO. TVPE OF FIXTURE OR 4TEM FEE nIH NnNDLING UNIT- C.F.M. � <br /> �WAT[P CLOS[TIiOILET) 5 INCINEFiHTOfi I <br /> BAiHTU6 _—t— <br /> LAVATONVIWASH BASIN) � <br /> � SHOWGfi � _ <br /> � KITCIiEN SINK R OISP. SUO TOTAL 5 � <br /> , OISHWASHEN I _ . PERMIT 5 _ <br /> I.AUNDRVTRAV TOTAIFEE 5 I <br /> LLOTMESlYASHER 'fH13 PERMIT 6[COh1[5 NULL I1N0 VOIO IF WORK OR CONSTPUC <br /> WATER HE�TER 11ON l�UTIIOHI2E� IS NOT COA1h1EKC[� WITHIN 1�0 DAYS, OR IF <br /> UqINAL � CON^vTfiUCT10N OR WORK IS SUSPENDEO OR A(3ANDONEO f-OP A <br /> ORItJKING FOUNTAIN �-q1UD OF 1J0 DAV; �i ANV TIME l�FTEFi WORK IS COMMENCED. <br /> FLOOR-SINK OR ORAIN � MEREpV CEf1TIFV THAT I HAVE READ ANO E%AMINEO THIS AP� <br /> VACUUM�PEI�KEflS PVCATION AND KNOW TH[SA�tE TO�E TRUE AN[)COi�RECT. ALI_ <br /> PROVISIONS OP LAWS AND ORDINANCES GOVERNING TNI$ TVP[ <br /> FOOF pRAINS-FAINL[4DER5 _ OF WOFK WILL �E COM1iPLIED VJI1H 1'JHETH[R SPECIFIE� H[REIN <br /> SINK (SERVICE-pAR,ETC.) OR NOT, THE GRANTING OF A PERM1IIT OOES NOT Pli[,�UAtE TU <br /> 61V[ �UTHORITY TO VIOLAT[ Oq CAP;CEL THE PROVI$ '�NS Of- <br /> �NV OTH[R STATE O(i LOCAL Ll�l\' P[GUI.ATING CUNSTfiUCT10N <br /> ORTHEPFRi 1Rh1�NC[OPCONSiNUCTIGN. <br /> SUBTOTAL <br /> PERMIT 5� <br /> TOTALFEE 3 � �� <br /> X <br /> SiGN�TVH@OFCOt,ITfiAC1UPOHAUTN.AGENT DATE <br /> 310EYARDSETOACK STREETSGTI3ACK FEARYAHDSETItf�CKFLANCMECKNUAtpER PLANCHECKF[E <br /> PEE FECEIPT NO. <br /> US[ ]ONE LOTANEA VACANTi1TE <br /> ❑ves ❑No FEES VALUATIGN PEE <br /> iVPE OF CONST. OCCUPANCV GflOUP UNIT�S DWELLING � <br /> —4 <br /> SIZ[OF pLIJG. NO.C� STORIES MA%.00C. LOAO �UILDING $ �� )j� <br /> PLUMBING � <br /> FIIIELON[ ItAtiL'd[N7 FIRESPRINKLEF� � <br /> (if�UIRED I <br /> G1y�� �ryp MECHANICAI I <br /> SPECIAL CO'JORIONS�. OTHEP � <br /> I <br /> I —_— ' T <br /> ._ --. PENELTv SEC.�OJ lal � <br /> I <br /> I --� TOTAL l�'I� <br /> I PGRMIT VALIDATION <br /> � WHGN PROPERLV Vl�LIOATED IiN THISSPACE) Tt11515 VOUR P[HNIT <br /> I <br /> I — <br /> � <br /> I <br /> � pnplilY.iiOiYhCf1('lCl]CV Ptf.NfiCMCIXWBY' R�pqpVCOfO(iI55UANCfOY � <br /> � La. <br /> I _' `' <br />