|
- �u:�� � r�u� i �uiv �
<br /> � �
<br /> � �'L►:N►IT l�i'PLlC/�1�10N
<br /> ' COft1f31Nl�710N • [iU1LDING • fl7CClil1NICl1L • I'1.U�IDING
<br /> �wHan ��ni�nuuu�..� .. .2 5� - / )
<br /> ar wwr+c
<br /> �1::��_.J:.�1..4�_ ��/.,t 7,/r._�:a�.. �,_...�/ `jF?C'i 2 5`!'/✓S 7
<br /> 41tGI1Tk(;IU11ul51(:Nl11 MnILAUU11l•.S
<br /> , IMONk UCINS� NU.
<br /> 3GpCRAlCO~Nf��ACTU❑ � •
<br /> MAILAUUitlii . PHONE • IICCN::CNV.
<br /> Sc �v�
<br /> LLC/IANICALCU�ITiIqGTUII MAIIAOpHE�S
<br /> 1'�IONE LICENSE NO,
<br /> 'IUMpINGCONi,IiACfOfI , MNlA0URE5i V/IONE " .
<br /> I�CEN5E NU.
<br /> 'E11nnT • "
<br /> ClA$S Oi 1YOnK �
<br /> �COMOINATION , . � . , '
<br /> ❑OUI�DING �PLV/d01NG �IAECHANICAI rl � .
<br /> ❑NEW �/1001TIUN unliEftnflpN ❑IIU�M11
<br /> IALUAT IUN OF ViOIIK --.. ..�_. .___
<br /> _ �C CO ❑DEAIOUSH ❑iENCE ❑51GN ❑':\VtMM�Nt: 1•ryOl
<br /> iESCn+UE UI1K • - �
<br /> aAcr ' cl..,.M � ' I �� 1�. / •'�-'�4 ' .
<br /> AUPOSED uSE � � ' �
<br /> OTNERPEn�'.IT$ ORAPPROVALS
<br /> r'�s_ _ ..� R E ZON E ,� S?ECIAL USE
<br /> tGA� 11k5CNip7�p,�UF VItUMEliTY ISI�OW 6ELOw U11 niTnb�
<br /> OUN CU�'iE51 �'""�
<br /> QT�OIOCK�_Of�_L � �--�CVARIANC[ .� Sf-'O�LINE
<br /> SE PA CIicCK lIST REQUIR[D
<br /> I� YES
<br /> Lj NO -
<br /> mnoontss c/l:ZY 5: ,.,�y� Z., _ - �._._ .
<br /> �c_<7�1 G✓r. 9F�e7 �G7ECHf1NICAl
<br /> lUfdI31WG � � Trvc or ENEHGY '
<br /> - �`�'+ ❑ELF.C. .
<br /> . NO. TY�G OF EOUiPrdCYT._. FEE
<br /> AIRCO:�O�VNITS-n.Y. Fh. —�'q"'--'j— .
<br /> 'U. ' TYPF OF FIXTUNE Oil ITE'd i fEE rtLffl�GCf: Ti0'lUtnfS.��Kf.A. _,_. _ _--T ,
<br /> IfAlll lUyti fs �- -._ ..._ . rt
<br /> (:IOIME51'::.ti11F:i1 i � _ OO�ICfI$ 11_P EA. .. _—' _"-i---� .
<br /> � oitin t�:.:���Fiis I 9_Y�r� —_ 'oncco'_,u, srsrEr.�: u_r.u:�ee'n.— � r—
<br /> — — t__
<br /> U111':!:1'-,-f�G1:`lT/1W$ �. � .. � �
<br /> FICOA UIIl.L•::i_- -� SPACE L �S.�ll uE.ttEnS . II.T.V. � � .
<br /> X KI ft:r�Fi! tiL'.`:J F. DI$�. � / O VNIT nc--'___"__"_'_ _'___� .
<br /> � ii.vi si�:Ks .— L U _ ___ �*en; n.r.u.---- - - �
<br /> - i C`/nvOr�.lriY[ COOlU�S �— '
<br /> IIOOF fiiinl� {IAIN I.I,Aq@I15---'_' --T--- '-' ClOi�isS UnvEnS'-"""----- ' -"-' � .
<br /> � SIIOC_t;i H.1 i r�5 � " _ '_"____' — � .
<br /> .---J-_ __.L�� v[r�Tiin;io��rn� -r— �
<br /> tieiivir.c si�+�:s— I — � .�..�_
<br /> tiU.':VS �� ti�.�._(r VU.11P { i�nn1,E ��000 � --' > .
<br /> _L '_'__'-"'__-....—_ ._�� ��1
<br /> • U�IC:.�L'i - ; nin �b1Vul�KG UNIT • C.f.RI. �— ��
<br /> �
<br /> � 17A I C Il Cl O':1..15--- � ' __ __"__'__'._.._ _. ..._ '_"___. _"_""' ' .
<br /> Y:.11lI1 l�f.ni'r.11__..ELGf__1171C � •WATEf11�EATLq '.-.• _- . • • _ _•••' " - '-r-�-
<br /> Y/.UM PaSL':5 - .--�-r�--- '"_ _' _.. .. . . . ._ _ _. '��-_ �
<br /> 1 i/ .'in Fn[. .ui�T r�wErinCE r. Crnr.�n[• _
<br /> l�lUl�'Uf1Y T 1.1VS . - --j`Y`- - ' �CAS�'vvSTEr.1: f�0 04• pV Tlh IS '•... T-- ' .
<br /> __ � . ' - '_'_'_ ... ..sVn tvrn� s J
<br /> - � �
<br /> - - � --- - - ---P¢nr:nr-_ _5 ..--_�Q�_ �.
<br /> -suri,oi,�i ;lr;� . Tnrn� ret_s �,�qC� �
<br /> `----•-
<br /> _ PFilfdli ' / , TIIIS YEfil.fl: pECD'.tE$ NUI 1. N�D Vpq1 U tVUllr, ilH C.U`�5iqlll i'
<br /> TOIAL FFE S �"��i_.� TIQV !.V filf)OI[CJ 1.'. NOI C(1`}r.�l UCiO Y��iIUN 1?0 UAv:, OIl IF
<br /> - I CUVSTIIUCI IUeJ O�1 1VDIIK c; r;v�.��rnoen nn Af1Ar:00.^.GO �OII .1 F�'
<br /> �TERSF.72VILESITE __Ltl)(: SUP7LY9ZF � •^CI11000t110Dnr5ninNrtn.tl. ntf[11Nf1nv, q:COr.:rdkNCE0. '
<br /> /� T' 'w---� i i�U�tnr GEniifv Iun1 i i�nvt ncnt� n�:n [rn�.�u��n nu: na. . ��.
<br /> J'e�T'i.1:t�i�lBlCn i7�ICCi`iilunCw�~THtnNtJn/R'�U9lluACc� pUCnTtU>lAr.qr:�:qvltl�F .^.A41EI(tl�linUf. nNUl'(�IutICL .1ll f
<br /> "' � I ��rY �(J.(�'�"`'1r tt �l1fIVl::it:NS OF LA1•+i AtJU Qf1pIt�AVCE$ G4VCf1Y�hO fn�S iYv:
<br /> �C ZUN! LU1 AIIIA, ' -�L�f Uf 190OK �•nll ul CO�dYl�CO v/iii� NnqT1�E�� ::vfCiflfU uFnCIV
<br /> vnCnN($Iik 1 Oli NOT. THF C.1111N:IN� Of q YFl1•.Ili pOCS ':OT YqESV:!C TOI
<br /> �- I . • ' re+ j, (llvF nun�Uui�v i0 vlOtnrF U�� C.1NCtl inE �'11[IVC:i('iry$ ps
<br /> ❑YCS UNO 1 nHv Or1�Ef1 SiniE U�1 LUCAI lnt9 ul.r:�!� n1iNt: (�ONtiTilUCT10N �
<br /> PE Uh CONSi. UC'CUYANI'Y (:IIUVM NO Ui�pWtlllN(i � .'ll 7ME Plftl01U,1ANCE Oi CUNSif1UGfD�N.
<br /> `/ VN115 �
<br /> �..4._� '�'�'__ _ �
<br /> .E OF UIOQ, NO.OF 5T0l11l5 Mnx,OCC. LOAO •
<br /> - '�_�� c�,' � � X..�.�.z_/ ��-_— � �1z�1�
<br /> It2i)Nk IIA::lMINI 1111L:.1'111NK1.1111•� "�GNnTVf1EOf • fll� �1CTOIIUIIAVTII.A(iEtJf O.1fE �
<br /> , 11 L U V I H L U ".�^_-.."'�"�^""'^.'�^...� w�.�aw�.. � .
<br /> � r1Y[: p�NO 'I..NClllInNVMJI�, 1'LANG�LIAIIL
<br /> U U ��[ . ntcurrNn.
<br /> �unc coNo�rioN;: ' �
<br /> - ' -� v��.-_... �2.�'�= ... . _ .�Z�Z��. .
<br /> FLCS VALUATION fF.E
<br /> ��___�.� _' �___ '�"'.r��
<br /> � , 1
<br /> __ � ' "'"___ _ _ t_
<br /> � • I uui�mNc =c„/.�C �:! . .- /`
<br /> ` •- -�----•-- — J�c?,�U
<br /> �EPA R[VEC��J GOhiPIET[ � ❑YES ❑ IJ—O' '•�""'"'"'� /✓ � C�
<br /> tontact plann�nq Japt. �,ic�i�Nic�i +.._ , �
<br /> . ._ , _ . Lo,00
<br /> o,����� �
<br /> _ �
<br /> . N�I�IiN�l11111Y�{ 1AA�l��Il�1Y�I' ••�� � .
<br /> , ,�.+o.io�.t�.. � rtNAltv LCc. Jo)1.) 1
<br /> . � �
<br /> !-; i ., 1 � _ __-_'______ _""'..�....._ _._7..._�l_�1�.
<br /> ..._.. �__._.. �___"___'� � ` � .. iOiAl '_"_ /�J !L�C�
<br /> i.
<br />
|