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� - i:ONSTRUCTION <br /> PERtV11T APPLICATION <br /> COMa1NATION • E3UILDING • MECli/�NICAL • PLUMDING <br /> UWNf fl <br /> �- . ' MAILAUUIIISS LIY IMUN! ' . <br /> /1NCMIiLC1 UN ULLI;:Nl11 � /..� % . <br /> , MAIL AUUt1E.^.S . PNUh/E <br /> __.' -- ; . _ ..� UClNSI NU <br /> �' i ��,;:..f..i , .. .�:. � �. , . � .. �: �� � .. , , . � , . <br /> GENIRALCUNTf1ACTON /� .JIpIL DNC55 ��,' PMONE <br /> , QV Q����' �;p{)/Vi,��O ".. � � . LICENSC NU <br /> -��e �_�,.�_2�%3 �'��T6f1e`�., /Z� .� �' S�7^��S— <br /> MrC1/ANICA��pNiNACTOfi � MAIL ADf�RC55 FNO��' <br /> K NSk <br /> PLUMtlING CUNTNACTOH �V' �!_�-✓' - <br /> MAIL ADUNk55 PMONE UCENSL NU. ' <br /> VfRMIT CLASSOF WU11K '-"- <br /> ❑GOMBINATION • <br /> Q�OVI�DING �P�VMBING �MfC11ANl�A� <br /> � ❑NCW AOOITIUN ❑ALlEIInfiUN ❑HL�•nlll <br /> VALUATIUNUFWURK —� •-._. ....______ <br /> > <br /> ; � `J `i �. ❑DEMOUSH ❑iEI:Ck ❑SIGN ❑';1yIhlMiNti 1'OpL . <br /> iDlS�'� IUEWpHK / _ � <br /> �� ,y J -/ �' 1 <br /> .� I �•�.n �'� �, � �� •, , . . . . ,� �-�L'�L"t•e�.....:yi�. <br /> vAorosto usE OTHER PERh51T5 OR AP�'ROVAIS <br /> �. r �' '` ."'. ;,. . - <br /> IfGALOMtiCf11PTWNOFVf10PERTYfSH01Y(IELOWOHATTACN � REZON[ �( SPECIAL USE <br /> coun cov�tsi , . <br /> �or� � 'e�ocK_oF %- '• ' �VARIANCE .r.� SN.ORLINE <br /> SEPA CHECK LIST REQUIRED <br /> I� YES <br /> � �'0 ' <br /> Jcc nooeEss <br /> _ � � � , ;,- , -�_ <br /> _ ' Ci�' � O i C ',.� r- . � . � MECHANICAL ^, -� ,. "�'- <br /> PW�dBING . /� .��, ;, ,�- TrvtoFcrvc��or <br /> ' ❑.ns ❑F�ee. <br /> . � NO. _ _ TVPE OF EOUIPMCNT _ FEE <br /> AIRCONp.VN1T5-II.P. EA. ' �S � � <br /> NO. TYPE OF FIXTUfiE OR ITEM FEE RhFNIGCfiATIONUMfti IIP. EA. --� � <br /> HA111 TUEIti S ' - "�__ <br /> CIOir.'SY7/15HFH � OOIlLi15 I/P EA. •_ ..-""-"" � <br /> UISN Yl15HER5 FORCED Alfi SYSTE!.0 Ii.T.V. MEA. -L-T- � <br /> 1 _ _"_"_.� __�._. ...�._ � <br /> o�+wr.iric FourarniHs i , � i <br /> H C:OH UIIf.L'.ly � $VACE b WAIL NCA7CR5 N.T.V. r— � <br /> KITOIIFN IIN�:1 f4 qISP � UNIi 4knTERS N.T.0 � <br /> IIAII SINKS � EVl��OnATrvE COOLCNS —�- - <br /> NOOF DRAINS t7AIN LCAVEIIS T- CIOinE50nrEP5-""--- --�-' � <br /> SHO1lFq HATHS y[NTILATiON FAN �-T <br /> tifi��ViCE CIN✓,S �'— �- � <br /> 5UMP;; .. yE\VA(iE GUMP FANGE 1�000 ___ � � <br /> -'___ _'___"' <br /> _ UHINAL$ � __ AIN IlpNpltNf.UNIT 0.f_M. �� ' <br /> . .�� _�_"_'_ ". ..... .._ ..�..� ' ___ <br /> _ wnie�� r.inse.Ts � _. � <br /> ---- . _ ...--- .._.. _..._.. <br /> wniE�� �n:ntFiis �� ei.eci�i�ic � WATEN HEATER ". . . ' ' '- '-T- <br /> - � - --� � -..,-_ <br /> WASM dA51N5 � � FAC. OVIIT FIRfPLACE F C�nMNEY � � <br /> _ LAl1NONY TIIAVti " (iA5 Sv$TEM.' NO OP OVTIi 15'�'-.... . -�"T-- . <br /> — � . - �---�-- ' 'sun iorn�i 5 .j�— . <br /> � — '_-_.____ •ENMIi ._5 .._...�.___r_ . <br /> _ � _"'______'_' '" _.'"""""' _ '__ __1 � <br /> SUO TOTAL 1nTnl. FkE' S � <br /> PEF17dlT S Ti11S VFf�h1R pL:OMES NVl l �ND VOib �1 �Vllit� �iH �]UNtiTRUC � <br /> iOTAL FEE $� TION AUt��OfiiLCO ti NOI f.UUMINC[U WiT1�iN f70 L'AV!:, pp �f <br /> - CUNSTIIVCf1UN O�i WD'�K 1!: !:U::�9�NOCO O11 A111NDONCD FOft 1 <br /> WAT[R SC.RVICE SVC- BIOG. SUPCLV 512t �'En10D O�' 190 OnvE nt nNv nMl A4 TCfI WOfI� i!:C(�R•iJkNCkU <br /> • i � Cn 1 ., UACR RLANYAHUStiHACR� I IICNlIIr CFIITI'♦ TIIAI 111.\VC IIEAU ANO CCAMiNifl TInS AT � <br /> NVCATION ANp KNOW TIIE S4MF t0111; TH�tE ANU CI�HItfCT. ALL <br /> � PPf1Vl:{iDN$ J( 1 A\YS ANf] qI1pIN�NCES COVCIiN�NG In15 TVP[ <br /> Uit 2UNl W7 ANLA OF N'OIIK YnLI dE COMvII[U W11�� WNF.THEfI ::MfCIFilb r�FREIV ' <br /> VACANT SITk ^- OR NOT, T4F 6PANTIN6 O� 4 PEPM1IIi nn[^ NpT PNESUM[ t0 <br /> ' ❑YES �'�VE �VT��OfLTY i0 y101Af[ OH �/1NGl1. TI�E NppylSipNS Of <br /> . ❑NO , qNv OTRP.R STATk Ofl LOCnL lAW 11LGVLATINp([ONtiT11UCT10N <br />� Tr�f V1 CONST. UCCVPqNCY(:NVUY N0.0! UWLLUNG Oli 7Nk PCIIFOHMANCE Of CONSTIIVCTION <br /> VNITS a <br /> 512E OF OIDG. NO.OF STORIES MAJt.OCC. IOAp / � <br /> x z'�'*' 4 • <br /> �1'IHk2(INt� IIA::1MlfJf Illi�1,1'HINKIUIti 5 IITUIIC�1fCONTq4C10110NAVTlI.q(iLNT pATC'• <br /> P[QVIHfU -1 l.W1111.C� NUAlUL11 1'LIINCRLCAIII � <br /> ❑Yf i ❑NO � <br /> //� r iRC o 11[CEIPtNt� <br /> 5..��n� �UN�i,i�NS: � / (/ s�� �� l 3.xzfl� � <br /> ��FEES VAWATION FEE <br /> --- --T- -"'T_ <br /> ��_,_�_ � <br /> _-�_' , IIUILOIN6 s • •. - _ � <br /> _ _� � " ' _�_ _. '.�_""�' 1 <br /> SEPA REV(EW COMPLETE � ❑YES ❑ Np ' """"""" V � V <br /> ' .- •----.. i <br /> COII�OC� PIOOI11Oq (IOPL MLCIIANIUI . � <br /> 1 <br /> - . .. �'�.... <br /> � OT/rtN ' I <br /> I <br /> w��cuwM��urnu�r �UbINIINU��' urMrr�o o�rru+wi.��r YFNAIIY SEC.7071d `-- 1 <br /> . . /' � "___'__ _.._... "" ' _ '_.... L_ <br /> TOTAI � <br /> ___.' "'."___" '."'_.'_' ' _"'—_ " _. ' � ���� <br />