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IfAc Evrrqrcr�r <br /> �,, ,, <„ CONSTRUCTION everetfi <br /> eVeTett PERM�T <br /> ��,r.,:,, � <br /> ,��,��„ ::�t,.��::'�;���: <br /> ��.,:�, <br /> °�°� °` �°''•,°�"° BUILDING MECHANICAL PLUMBING <br /> otvuorv.txi <br /> OWNEH �wy ��� �M1AryI�L /�DO*RESS 4P i'HONL {� �[ <br /> .��fM �"�l �':•.L J�'C7 J'.XiiJi 4tl� �•.ls� r{7-�IV <br /> 4RCHITECT OH DESIGNEP MAIL ADUfiE55 PHONE LICLNSE NO. <br /> GENEflALCONTRACTOF MAILADDRE55 PMONE LiC[NSE �U. <br /> '�L t'�".�Y ?;3� L:��"IL F?'at�: T+!Y. .3,}'ItS�} 223"�t-37t12 <br /> MECMANICALCONTRACTOR MAI�ADORE55 PHONE LICL�\SE fv(`. <br /> PLUMdING CONTfiACTOR MAIL/1DORE55 PMONE LIC[N5B NO. � <br /> W <br /> m <br /> PEFMIT CLASS OF WOflK � <br /> z <br /> [�pUILDING �PLL^.161NG ❑MECMIINIC4L H <br /> ❑NEW ❑AD�ITION �t1LTERATION ❑R[PAI(i � <br /> VALUATION OF WOPK IY <br /> 5 � I ❑OLMJl�SH ❑fLNCE ❑SIGN ❑SWIMMING POOL a <br /> DlSCRIAC WORK <br /> $rt-tt� r �x�L r#�m�� t���.�-,�.��� :�s 398 <br /> anor�oseo use MECHANICAL <br /> LLG�11.DESLLC,�HIPTION OF VPOPEHTY ISNOW fiELOW OR ATTACM T��L O�' 1-ULL �UIL L�NnT. �IPG. �ELEC. <br /> Lo1ri��^"Ulo[K�OF '�� ' r�� ___ NO. ___T\_PEOFE�UIPMENT FEE <br /> 41R COND. UNITS� 11.P. GA 5 I <br /> RBFRIG[RATItIN UNITS -H.P. EA. � <br /> OOILERS-HP. LA. � I <br /> GAS FIqED A.C. UNITS- TONNAGE EA. <br /> FORCED AIR SVSiLM1iS-❑.T.U. M EA. I <br /> J09 ADD(iE55 W�+LL HEATERS �B.T.U. M <br /> � �.����� <br /> VNIT MEMERS-[3.T.U. M I <br /> LVAPOHntIVE COOLERS <br /> PLUM6ING CLOTHLS OfiYERS i <br /> VENTILATION FAN � <br /> RANGEHOOO I <br /> NO. TVPE OF FIXTUF'.E OR ITEM FEE Q�N HnNDLING UNIT�- C.F.M. <br /> WATEIiCLOSETITO1LETi 5 INGNERl1TOA I <br /> [3ATMTUp <br /> LAVATORV(W�+SH BASINI � <br /> SNOWEH <br /> KITCH[N SINK&DISP. SUB TOTAL 5 � <br /> UISHWASHHH PERh11T 5 <br /> LAUNDfiV TFAY TOTAIFEE 5 I <br /> CLOTHES WASHER THIS PEfiMIT BKOMES NULI ANO VOIU IF WOftK OR CONSTqUC� <br /> WI�TCP 11[AT[R TION AUTHOR12EIl IS NOT COMAIENCCU\NITMIN 120 DAYS, UR IF <br /> URINAL CONSTRUCTION OR WORY. IS SUSPENDED OA AOANDONEU fOR !� <br /> DRINKING FOUNTAIN �Efl100 OF 120 O�YS AT ANY TIh1E AFiER WOPK IS COMM[NCEO. <br /> FLOOfi-SINK OR ORAIN —� 1 H@FlEpY CEPTIFY TMAT I HAVE READ AND EXA�IWLO TMIS AP� <br /> VACUUM 6fiEAKERS �'LICl�TiON AND KNO�Y THE SAhtE TO 6E TRUE AND CGRHECT. ALL <br /> fi00F D(iAINS-RAWLEADERS I PROVISIONS OF LAWS AND OIiDINANC[5 GOVF.HNING 14115 iYP[ <br /> _ _ OF bVOfiK WILL BE COA1VlIGU WITH lVH[THEfi ;PKIREO HEREIN <br /> I _ SINK (SEflVICE-�AR, ETC.) GR NOT, THE GRANTING pF .� PGRA9IT �UES NOT PRESUME TO <br /> GIV[ AUI'110fiITY TO VICLATF Oq CANCEL IHF PROVISIONS OF <br /> AN\' OTMER ^Tf1T[ OR I.OG�L �,119 FEGULATING CONSTPUCTION <br /> �_ OH THE VERFORMANCG OF CUNSTIiUCTICN. <br /> __ SIUTOTAL �_ <br /> _ P[qMIT 5 I <br /> TOTAL FEE 5 �„� <br /> X �71�.f� <br /> SI�R60-CONTfil1CTOPONAU I.AGENi �A�[ <br /> $IDL YARO S[TI3ACK STFiEET 5ETf3ACK REAR VAFDSETIIIICK PLAN CHCIX N�M6ER �'LAN CHECK FEE <br /> FEE R[CEIPT NO. <br /> USE ZONE LOT A'1EA VACANT SITE <br /> ❑YES ❑No FEES VA�UATION FEE <br /> TVPE OF CONST. UCCUPANCV GROUP NO.OF pWELLING <br /> VNITS � <br /> SIZE OF BLDG NO. OF STORIES Ml�X.000. LOAD 6UILDING 5 l�.�yy� '�r � <br /> _� <br /> �WM�ING � <br /> FIREZONE 11ASEMEM' FIHESPRINKLEIiS � <br /> i�COU1pED <br /> ❑YES ❑NO ��[CHANICAL I <br /> SPECII�L CONOIilONS: UTHER � <br /> I <br /> _ PENELTY SEC. 30l fal � <br /> — I_ <br /> - TOTAL S�`j � <br /> PERMIT VALIOATION <br /> \NHLN PROP[RLY V�L�O�TED IIN t1115 SP(ICE)TI65IS VOUR VERAfIT <br /> — I <br /> FPI�1�'n;iit'.:�(ll�ifl�I1Y �It.Y.('�fCKfl)I�♦ n�pflOVED+�O(il.�$Ilr'.1:'C11Y <br /> I l.� �� <br /> I .� <br />