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�In� f:�'er�ree�i � � <br />��,,,,, . � �ONSTRUCTl�N � <br />eve��tt ���n�or PE►�M�T �o. c. �����.; <br />��r, � <br />�:�:,, � , L� CGMBINATION LJ BUILDING L� MECHANICAL L_i PIUWIBING <br />,,...,. r,�,� aoc��Es:; arv cn� ,... <br />2510 19t1i Street Vern S9. Russos <br />..,., �_.- r,� r:,e,�.� �� �.,<.�.i :.ouress cnr [r., r�rouF <br />.,. ..I:.l CONiRFG10R 61AIL /.I)Ul.�SS CIiY ZIP �'MONE UCE�e. <br />.._ ��,9r'�LC9��1�Ci0P LIAiLF�I)PE55 CItY ZIP PNON'_ LiCE�li:� <br />Natural Gas Equipment 1611 East Grand <br />n���:�mr,cou�aFcron i+H��2ooi�ss ciTv zm anoue ucur,— <br />Q ��',� OP YlOflN <br />❑NEV✓ ❑ADDITION ❑ALTERATION ❑REPAIR LIDEMOLITION ❑FENCE ❑SIGN ❑GARAaE <br />::.i �snou eF wor+n <br />Di�.sCR'�l3E WOFN �— <br />.��i OSED USF 0� BUILOING <br />i i„:; UF.SCaIPt I04 OF PROPERiV ISHOV/ BEIOIV OR ATTAQI <br />, (3LOCz__OF _ <br />J011 ��... �._o• <br />257.0 19th Street <br />PLUMB{NG <br />UB <br />OR ITEM <br />CLOTHES WASHER <br />WAT[R HEATEii <br />URINPL <br />DRWKING FOUNTAIN <br />FLGOR DRAIN <br />VACUUId BREAKERS <br />ROOF URAINS — RAWLEADFRS <br />SINK ISERVIC[ — BAR, ETCJ <br />SIU[ VnRD SEIBACK <br />USL ZONE <br />il'PE OF GONST. <br />tiIZE OF OL�G. <br />FIRG ZONE <br />SUO <br />I HEREBY CERTIFY THNT I HAVE READ AND EXAMINED TH!S AP- <br />PLICATION AND KNOW THC SAME TO BE TRUE AND CORRFGT. <br />ALL P�IOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH NJHETFIER SPEr!FIED <br />HEREIN OR NOT. THE �RANTING OF A PERMIT DOES NOT <br />PRESUME TO GNE AUTH01?iTY TO VIU�TE OR CANCEI THE PRG� <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW FEGULATING <br />CONSTRUCTION CR THE PERFORMANCE OF CONSTRUGTION. <br />s�Gumu��! p� ;_,•u�,nt.i0ar,.�nun�or,2FD:.yEN� oaik: <br />X . � : •, : i/ <br />MECHANICAL � <br />FEE NO. TYPE OF EOUIPMENT <br />AIR (.ONO. UIlIlS — F� P. BA <br />FEFF13F.fiAilON UNI�S —� 11 P. El� <br />BOILERS — HP.EA. <br />GAS FIRED A C. UNITS — TOIJNAGE EA. <br />FORCED AIR SYSTEIdS — �.i U �+� <br />VlALL N[ATEPS — B TL. M <br />UNR HEATEPS — � 1.U. �� <br />STREETSEi�ACK �EAR YAHD gET3ACK <br />LOT f.HEA VFCANT SITE <br />NO. OF 51 C <br />�ASEMENT <br />t. [NVIRONMENTALCHECKLIST <br />^. I3UILDING PV+NS <br />� FlHL HYDRFNT <br />� f�IRE PROTECTION SYSTEM <br />S GPADING _ <br />�1 DRAINAGE <br />7. [NVIROIVMENTALIMPACT STATEMENT <br />9. HEALTF DISIRICI <br />�',YES (�NO <br />GROUP IJO.OF DWEL <br />LOFD <br />'NO <br />APPLICAiION f.(.0 fi'i � PlANS CHECKED �V � APPR FOR 16UApCE E3Y <br />VENTILAiION FAIJ <br />anNae i�000 <br />AIR HANDIWG UNii — <br />STOVL <br />MFTAL RREPLACE 8 Ch <br />BUILDING <br />PLUMOING <br />1dECHANICAL <br />OTHER <br />PENALTY <br />F.h1 <br />SUBTOTFL <br />PERMIT <br />TOTAL FEE <br />NUM�[R PIAN <br />fLF <br />FEES VALUA710N <br />5 <br />U.B.C. <br />SEC.3031a) <br />RECEIPT NO <br />ree <br />� �� <br />� �� <br />PERMIT VALIOATION <br />4YHEN PROFERLY VALIDATED �IN THIS SPAC[� 1HI515 YOUR P[R1dIT <br />E�82 �QO�j.O�x��' <br />�' <br />, y cfj <br />'YOl}R RECEIP�� <br />T!-iF�NK YOEI <br />:.������� �-��� 2 �i wc 19. <br />