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- CONSTRUCTION <br />PI WI AIT APPLICATION <br />COMBINATION • BUILDING I, MECHANICAL <br />• PLUMBING <br />OW tl/ // MAIL AUUIILSi YIP _--- I'IIUNL <br />9 7`cf 13e'l �z s"`r—-• <br />ARCIII1EC1 O11 ULSIONLI/ <br />MML AODIILSS PHONE LICLNSL NO <br />___-..- <br />Gk N Lf1_ALCCNTIIACTOR <br />MAIL AUURE55 , PHONE LICENSE NO. <br />! C.IE/1/�kSnlLJ �z�?� <br />��ILkG/D2- 7--.> 9 ('N�Z FDl3L PCL: 239 LU <br />MLICHANICAL CUrl Tf[ACTOR <br />MAIL AUOFIL55 PHONE UCENSt NO. <br />PLUlAUING CONTRACTOR <br />A,AIL AUURLSS PHONE LICENSE NO. <br />VLIIMIT <br />CLASS OF WORK <br />❑COAIUIN ATION <br />❑BVILOING ❑PLUMBING ❑r,ILCIiANICAL <br />❑NEW ❑ADOITIUN ❑•1LTL(In f1UN ETltEPAlll <br />VALV ATIUN OF 1VOIIK <br />❑OEMOUSH ❑ILNCE ❑SIGN ❑'i\VIMMINt: 1•HOL <br />�'!, 1 <br />� <br />PROPOSED USE <br />OTHERPERMITS ORAPPROVAIS <br />p REZONE SPECIAL USE <br />_ <br />LLLGAL 11L 5C RIP1IUN OF 1•Rp VE RT 1' ISIIOW BELOW <br />FOUR COPILSI <br />UR ATTACH <br />[VARIANCE SHORLINE . <br />_ <br />SE PA CHECK LIST REQUIRED <br />I:" YES <br />L� NO <br />_ _ <br />1O0 l.DDHL55 <br />- ' <br />MECHANICAL <br />o I I_I�bin <br />— <br />TYPE OF ENERGY <br />❑fi AS ❑[LEG <br />PLUMBING <br />- _-_ _- <br />NO. TYPE. O_F_EOUIP RENT <br />_ _ <br />j AIR COND. UNITS-H.1'. EA. S -_��- <br />rJU, TYPE OF FIXTURE OR ITEM <br />__- <br />FEE REF nllit llnnoN VNITS_i_V^EA --_--- 1_- <br />-- <br />OA711111US <br />-'S BD�LCRS H.P, A. _• I <br />�----�--- <br />CLOTHES VIASIIE II <br />I y PURGED AIR SYSTEi,Is 11. T_lL r.1CA. <br />--- .. ..._ --� -- <br />111511 wAsmuls <br />_ <br />�- 1 1 - •-•-- <br />_ <br />UILI7 51PJG F(1lF JTAI7:S---•L <br />SVACF. 1. 1YALL HEATERS R.T.V. _ <br />_ <br />I4OUH DIIAl1:5 <br />I 1 <br />UNIT HEATEss R.T.V. 1 <br />t[I1l114LN SINKS N UISP. <br />CV APO RATIVE COOL[ 115 --- _, <br />IJAII SINKS <br />ISO(1r OIIAI(JIi RADJ I.EAUEt[S `_ CLOT14LS UIIYERS 4 I <br />SIID:.LR IIAIII$ VENIT LOTION FAN 1_ _-T— <br />_iENVICE SRJVS <br />SkWAGIZ PUMP <br />_. UI4INALS <br />I I RANGE <br />I At RANULIN6 UNIT GF_M. _•,__-,J-�- <br />-T- <br />A'AU,l CLOSETS - <br />I _ <br />wn TER NEATER <br />.__..__. <br />\VAT LII HE AIEHS ELECTIIIC _-__ <br />I _ <br />1 '- F.1 C�OV ILT FIR EPLACC W CII ILIN EY <br />--�-- <br />GAS SY 5i C1.!:-NO OP OV Tll 15 •,,,�._,- <br />L l_111C U11Y TIIAYS <br />_ <br />-- - <br />-� <br />1-'----------_---TfIiAL EEL' S I <br />— AUU TOTAL <br />--� __ _ <br />-T IIECOMlS tJlll I ANTI VOtU II wolllf IlH la?ASTRUC <br />_�_ 1115 VFIIr.11T <br />S1} i TION AUTHORIZED ,S riot COMIALNCt ll IV1711IN 170 UAY7:. OR tF <br />_PERL_IT <br />TOTAL FEE <br />[I------ Cl?rv::T I1lICtlO'J D1I LVORK , 5U::l•I'NDLU Oil AIIAND O:<CIT FOR 1 <br />BAYS AT ANY (IMFTERWO111: I•:CD'dtIENCL D. <br />:ATCII 51iR\'ICE SVf.__ _RLn G. <br />«p'-'Y•r^'-^'«'�'vsr°^"-^^"'•--•�^� <br />SUPPLY SIZE__ 1•C III OD D1' L'0 .At <br />- I IILIILIIY CERTIFY TIIAT I IIAVL RLAD AND C<AA'IIJIR T1115 A- <br />S.u:U TTLLT SL11a•LK <br />HLAl1 \'Al1USk IUACK PL ICAT ION AND K NOW I I I C SAME T O III, T ItU C ANO CO 1: III C T. ALL <br />IUL nL luAler, <br />r IlOVISIONS OF I. AWS AND OBOINANCES GUV[RNgJO TIPS TYPE <br />YIILL'UF EOA!PLIEU IVITH Y:I11:T11E11::1•ECIFILD HERCI\I <br />)::L f. [I NL - LOT (.IiLA <br />_ OI' wO11Y, <br />VACANT 51T6 •_I all NO1, Till (f11AN:ING OF A PERMIT DOL$ NOT PHCSU'fE TOI <br />TO VIUtAfL OH CANCLL fllC I•IIOVISIONS OF <br />• <br />LIVE AUTHORITY <br />❑YCS ❑NO ANY OTIILR STATE OR LOCAL LAW Itt-6ULATING CON:,l ItVCTIUN <br />T OilT/lt PLIIF ORMANCE OF CON511tUCT ION. <br />I I'C UT CDNS1. UCCUI•A1,R Y 1;' VP <br />UNO Or -- <br />NITS UWtlll(JO <br />:IZC OF ULUO, NO. UOF STORIES <br />MAX. OCC. LOAD r, <br />- <br />_ <br />_�,w1 <br />I T1111LUH n UTIt. AV, L NT 15.1TL <br />IIIL IIASE MLNI <br />_— <br />IIIil 51'IUNKl lllti �^���,Y„v:.,w�a...�+�+d rea+�- ^v "•'�"' '•" <br />HLOUI111-,1 PLAtJ LIILCA NUARILII PLANLIILCKILL <br />❑YLS ❑NO TLC RECEIrT NO <br />'LCIAL CONDITIONS: <br />'I <br />----FEES—_FETE <br />—VALUATION <br />_ 1 <br />IIUILUING s.. Y i I)�� / sL of 10 a <br />I <br />SEPA fEV(f W COII{PLETE ❑YES <br />D NO --•--•• <br />coDloEl plDnnlnq dRpl, <br />I <br />RILCIIANICAL <br />OTI1C11 _ <br />-^� ---- SEC. 3031Y1 I <br />•11[All•1!I J.LUIIIUYY .t/1M1Y411l4UYI F11'/01111 IyKP:A, 141 v 1'E TALTY ..... L. <br />