Laserfiche WebLink
�i <br />'l-lullio [ [c u < OWN" ...• evcrcit <br />e L".1... <br />[/ <br />PERIViff <br />"If"Alt IS,IH{ <br />1,fv <br />°"L ""`""'" BUILDING MECHANICAL PLUMBING <br />C'f :11PrvlNf <br />UWNLI/ 1 <br />MAILAUUHLSS 2R <br />li���-�� <br />ARCIIITLCI OR DESIGNER <br />MAIL ADDRESS PHONE 7 <br />LICENSE NU. Z717, <br />GCI'EpAI CUNJ /TOR <br />/ <br />MAIL ADDIIEBS MNONE LICENSE NO. 3S 3 <br />M LCHANILAL CONTRACTOR <br />� <br />/ ! / � -y ` /,� �+ 3.���C n �� b�/ <br />MAIL ADDRESS PHONE LICENSE NO. <br />PLUMBING CUNT RACTOR <br />MAIL ADDRESS PHONE X <br />-� <br />LICENSE NO. OJ <br />PERMIT <br />Ill <br />CLASS OF WORK r <br />❑ BUILDING Cl PLUMBING [] MCCIIANICAL <br />❑NEW ❑ADDITION [•]ALTERATION REPAIR <br />VALUATION OF WORKcc <br />�• <br />Ile <br />Cl DEMOLISH ❑FENCE ❑SIGN []SIVINIMING POOL LU <br />D ESC HIDE WORK <br />O. <br />PROPOSED USE ,. <br />_ <br />MECHANICAL <br />I <br />-- <br />I.EGAI.DESCfIIP710N OF PROPERTY (SHOW OELOW OR ATTACH TYPE Of FUEL OIL nNAT. ��PG. �ELEC. <br />FOUR COPIL I <br />;� CL'C'11-00 // i <br />GAS <br />LOT - OLOCK�_OF1� <br />NO. TV PE OT GOVIPAIENT FEE <br />AIR COND. UNITS—H.P. CA. S <br />REFRIGERATION UNITS-H.P. EA. -1 <br />BOILERS-11.P. EA. <br />�/^ G <br />GAS FIRE A.C. UNIT -TONNAGE EA. I <br />ILA <br />J00 ADDRESS <br />S��fi <br />FOHCEU Al SYST dS-B.T.U. MCA. I <br />WALL HEAT S T.U. M <br />-- <br />/ i <br />UNIT HEATER B.T.V. M <br />PLUMBING <br />EV_APORATIV OOLERS <br />� <br />CLOTHES ORYEILS I <br />I <br />VENTILATION FAN <br />�1 <br />RANGE HOOD <br />NO. <br />TY OF FIXTURIi OR ITEM <br />FEE <br />AIR HANDLING UNIT_ C.F.M. <br />lV_ATERC_O ET (TDILET) <br />U/1Tli-T I <br />$ <br />INCIN[RATOR <br />f <br />- <br />- <br />LAVAIOIIY (1 ASII tlAJINI <br />SHOWER <br />KITCHEN SINK YDISP. <br />i- <br />� <br />- <br />1 <br />-- <br />OISHIVASHF.R/ 1, <br />. SUBTOTAL S <br />LAUNDRY? AYE <br />I <br />PERMIT S <br />CLOTHES I•/ASHER. <br />TOTALFEE S <br />--^I <br />WATER 1 EATER <br />THIS PERMIT BECOMES WULi. ANDMVOID IF WORK OR CONSTRUG <br />TION AUTHORIZED IS NOT COMENCED WITHIN 120 DAYS, OR IF <br />CONSTRUCTION OR WORK IS SUS -ENDED OR ACANDONED FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AFTER WORK <br />- <br />URINA <br />' <br />OHIN_' NG POUNTAIN <br />FLO R-SINK OR DRAIN <br />7 <br />IS COMMENCED. <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS AP- <br />PLICATION <br />VACUM ORCAKERS <br />AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />RO F GRAINS-R AINL EA DE RS <br />PROVISIONS OF LAWS AND ORD114ANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE <br />SIN -ISEA\'ICE-BAR, ETQ) <br />--�-- <br />AUTHORITY TO VIOLATE OR CANCEL TI/E PROVISIONS OF <br />- <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR TI4E PERFORMANCE OF CONSTRUCTION. <br />_ <br />SUB TOTAL <br />P[IIM IT <br />$--�— <br />IUlAl-FEE <br />X <br />CITY <br />USE BELOW THIS LINE <br />A <br />SIGNATURE OF NTTiACTOH OR AVTH. AGEtJT DATE <br />S IUE YARU SLTSACK <br />STHLET SETUACK <br />I' FAR YARD SCTBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />VSE ZONE <br />LOT ARf:A <br />VACANT SITE❑YES <br />❑NO <br />FC-ES <br />VALUATIO <br />TYPE OP COHST. <br />OCCV PANCY GIIOUP <br />IJO. Of• DWELLINGUNITS <br />tnECCIPT. <br />SIZEOF HLOG. <br />NO. OF STURI .S <br />MAX. OCCLOAD <br />BUILDING <br />$FIRLSPRINKLERS <br />PLUMBING <br />HLOUIRED <br />MCCHANICAL <br />---�—__ <br />I <br />[]YES ❑NO <br />- <br />SPECIAL CONDITIONS: <br />OTHER <br />I <br />I <br />PENELTY <br />.•,EC. JOJ (e) <br />—� <br />TOTAL <br />I <br />�- - <br />PERMITVALIDATION <br />1VIILN 1`111,1-CHLY VALIDATFC (IN THIS SPArF.) THIS IS YOUR PERMIT <br />- ------ <br />�','„H�.0 IU'1 AIU YIIPF, <br />1'I PNi WIIl FI II IIY: <br />P0'IIIIYIp IB ISAIAIF:I IIY <br />i 1 t LI11,:11'.: CO3-i <br />