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r- <br />PERMIT APPLICATI®N <br />BUILDING MECHANICAL PLUMBING <br />OWNERC'MAIL ADDRESS ZIP PHONE <br />�'� <br />. <br />�6 <br />ARCHITECT OR OESIGNER' MAIL ADDRESS PHONE La <br />CNSE NO. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />MECHANICALCONTRACTOR MAIL ADDRESS - PHONE y LICENSE NO. <br />/ <br />PLUMBING CONTRAC R MAIL ADDRESS PHONE LICENSE NO. <br />' <br />CLASS OF WORK <br />NUMBER OF STORIES <br />❑ BUILDING ❑ PLUMBING WMECRANICAL ' <br />BASMENT <br />NEW ❑ADDITION, ❑ALTERATION ❑REPAIR <br />VALUATION OF WORK <br />' <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />S <br />DESCRIBS.WORK <br />Y <br />PROPOSED USE <br />LEGAL DESCRIPTIUN OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIES) <br />LOT. CLOCK —OF_ <br />JO0 ADDRESS <br />PLUMBING <br />MECHANICAL <br />TYPE OF FUEL ❑OIL oNAT. ❑LPG. PLOT PLAN <br />tic. TYPE OF FIXTURE OR I1'EM <br />NO. TYPE <br />Draw plot plan <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS-H.P.EA.1ENI <br />__- EA. <br />On backside. <br />DATHTU5 <br />REFRIGERA'fIOtJ UNITS-H.P. <br />S-H.P. BA. <br />LAV A T C AY (WASH BASINI <br />BOI LEAS-H.P. EA. <br />_ <br />SHO"Eq <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />KITCHE': SINK R DISP. <br />FORCED AIR SYSTEMS-B.T.U.M E ) <br />DISHW-SHER <br />WALL HEATERS-R.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS-B.T.U. M <br />CLOTHESWASHER <br />EVAPORAT WE COOLERS <br />WATER HEATER <br />_ <br />CLOTHES DRYERS ' <br />URINAL <br />VENTILATION FAN <br />DRINKIC� FOUNTAIN <br />FLOOR-cleK OR DRAIN <br />RANGE HOOD <br />VACUV." SRF.AKERS <br />AIR HANDLING UNIT- C.F.M. <br />ROOF CR.AINS-RAINLEADERS <br />INCINERATOR <br />51NK (SERVICE -BAR. ETC.) <br />SE ONLY BEL04J <br />SIDE YARDSETIACK STREETSETUACK REAR YARDSETOACK l <br />—ZONE <br />x L-. �� 0 7 <br />USL LOT AREA VACANT SITE SI TURGO C RACTORORAUTH.AGENT O TE <br />❑YES ONO PEES <br />TYPE OF CONST. OCCUPANCY GROUP O. Of DWELLING <br />NIN <br />UNITS PLAN CK _ VALUATION <br />BLDG PMT_ <br />SIZE OF BLDG. NO. OF STORIES MAX. DEC, LOAD MECII PMT I11,711 CK NO <br />—�— — <br />PLBG PMT <br />Fli{E ZONG BASEMENT FIHBFI'RINK LENS <br />• TOTAL <br />n1:DuinED <br />DYES ONO <br />)_ <br />