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- CflNSTRUCTION <br />PERMIT APPLICAT!��� <br />COMBINATION • BUILDING • MECHANICAL • PLUMDING <br />a <br />veRmir <br />�i ❑COMHINATION <br />� ,�'OUILDING'�PWMOING �MECNANICAL <br />VALVATION OF WOHK <br />�N[W ❑ADDITIUN <br />YNUNt <br />S`i=,23 � <br />❑ALTEII4f1UN �It{1'n�il <br />❑DEMDLI51/ ❑fENCE ❑SIGN ❑':\YtMM�INf: P�i01. <br />i/i /R6N <br />��GJ/N,(l /{C: GL�:�1 <br />� F:E ZONE �j SPECIAL USE <br />� LEGAL UF.SCHIPTION Of YROPERTY ISHOW dkLOW OR ATTACI� <br />��I ouecovies� �VARIANCE L� SI'.ORLINE <br />� � IEG�lDES�RIPTIO�J SEPA CHECK.LIST REGIUIRED <br />�: . .... . . �,._ <br />� .�' �:T ST Nt' tL' YES <br />tj NO <br />fl <br />PLUM6ING <br />', ,, I L <br />�_:,����� . (,,,,�_S�y �MECHANICAI . <br />� TYVE O� EN[R6Y . <br />❑r.ns De�e.c. <br />— ----. _ _ _ _ _----1---- <br />. NO. TYP[Of[OUIPt�tENT FEE <br />AIRCOND.VNITS-N.Y.EA.. ....—"""—t5""_"- � _— <br />ITFId FEE RLfRi(:EPATInNVN�fti IIY.GA. —_!—'_—r— <br />__1_— <br />5 ' • _ OO�llRS 1/.P EA..' "' _—.__--''_1__T <br />fORCED AIR SVSiER15 li.T.U. MEA. � <br />� _ �""_ _��_" "_�__ � _ _�' <br />� _'���_ <br />-- i —" $P4CG k WALI NEAiEPS P.T.U. <br />—'-- � UNIT nEnTEPS H.T.V. .�_, <br />�— EVl�Pp{1nTIVECOOLCH$ <br />1 <br />R$ _ � CLOTN60RVER5 '""_--_—_"—�—'. __ � __ <br />URINALSJ�••••••` y••• � NH HANOLIN6 VNIi _...... C.f.M. � <br />WAICn CLOSCTS � ' _' --- .' ... _.-.. . .'_ ..�_ � <br />_W�TE�i Hf:_AiEllti_ELECTRIC � _ �'�'ntEH 11EATCR . _ _ _,__ j__� <br />Y.'ASM BASIIJS - � FAC OUILT F'�REPLA[E !4 CIIIMNEY 1 <br />IAUNDIIY TIIAVti G45 $vSTEM NO OP OV Tll 15 _T <br />.... �_ <br />� ' . ._ — ._.. __ ..••SUf1iOML 5.... __ I <br />� '--'-"'" FERMIt �-5 �— <br />� _'__� �_�� _ � . <br />� SUO TOTAL ' ' '_ ' ' " .- TOTnL FfF ,5 _ _ 1_ � <br />FEfifdli 5 11115 PEf�MIT IIECQfdES NVI1. �Nb VQ�U il WUHY, ��H COkS�HUC <br />TION /)Vf110flIZELI I$ ND[ ('Ub141lNCf D WITIIIN 1?0 U.\Y'� nli If <br />TOTAL FEE 31— CUNSTRVCf1pN O!i \YO�IK �r s�::��cruoen on Af1ANOONCO iOfl A <br />NATEFi SERVICE S12F BLOG SUPPLY $12E ' YCf110D UI' 110 OAVS nT ANv fIM6 AF TEH WOfIK q: C(��•1G�FNCkU. <br />S i � 1. n���S�TOACK HtANYANUSlIpA(;K ����qF11v CEliTIFV TIIAI 111/�VC 11lAO ANf)E<A��WIf1 t1115AP <br />PLICN iPN AND KNOW THF S.\h1F TO 116 1IIVE AND CO�UiI'Cf. \ll <br />Vf10V1:�9N5 O� LqlVS ANU OItO1NANCES GOVEIiNING i1115 TYPE <br />pF WGNK IYILI UE COMYUEU \V�YN W��EIHF.I� ::�EOf�lO nERCI4 <br />USf 70N1 LC/ ANLA VACANf SIIt �— OR NOT, T�Ib GR�N:ING OF A PERbtIT ppCS NOl VRESV`.1E TO <br />� GIVE AUTIiOft1TV f0 V�OLAfF ON CANCtL T11E �'NUV�SiO�JS Of <br />� ' ❑YES ❑NO �! ANV OTM[R SiATk O�l LOCAI LAW HC<iULATWG COM:t1�UCTION <br />TYVEUF�ON57. UCCU.ANCY(iROUI' N0.0FUWkLLINti 1 ORTI/C�Ef1FORMANC@OICONStpUCTION. , <br />.....�.. J ♦ <br />1�1111 [liNl: <br />srcGn� coNo�*ioNs <br />� <br />�l0. LUNu � � � <br />X _� 1,,:--� 1:-_ /_ <br />•,NK'.-,'it. ` 5�6NnruuLofCONTnnC<nno <br />HEU PL.1N CHlln NUM9111 i <br />., oN�--i 1«r <br />nEtEirr r+n <br />_."_�.��....���"' ._ ... .._ �. . .. __... <br />FEES _T� VALUATION , �EE <br />� _�_�-r-. �..T�� <br />_ _— —I UUIIOING — <br />SEPA REVIEW COh1PlETE � ❑YES ❑ NO ' "�"""n'"" <br />tontoct p�onn�nq dept. MccunNicn� <br />� OTIICR <br />�l1 �IqNKUrl�u��. r�nwp�nll�1UW �M�Ov10 on�Wliucl�� YENALTY <br />' ' '_"_' — <br />TOTAL <br />_ ��C/ �xJ � 1 <br />--._—_�._— •- ��r--• <br />_ I <br />i <br />i <br />. � <br />. ... �'—... <br />. i <br />I <br />T�— <br />$EC. �OJ I�I � <br />_..."""��..._ '.7..L=_, <br />