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- C�NSTRUCTI�N <br />PFRMlT APPLlCATION <br />3��� <br />y/� /�� <br />COMBINATION • BUILDING • MECHANICAL � PLUMBIIVG <br />� <br />PERMIT <br />�C�MBINATIO�i <br />/ <br />�DUILOING �PlUM01NG �MECMnNICAL <br />l0T <br />%:t <br />31 `' -t�G'.'� ^ ' � _ <br />�1 , ',`., <br />D ijLSS <br />'I/ <br />;� <br />�. <br />LIC <br />��.: <br />❑NEW ❑AOOITIUN ❑ALTEfI/�fION ❑HU'nili <br />OEMOLISN ❑FENCE ❑SIGN ❑':WiMMINti f•UOL <br />)THER PERMITS OR APPROVALS <br />.a REZONE �j �PECIAL USE <br />�.:�",RIANCE � SF:ORLINE <br />S E PA CHECK LIST REQUIRED <br />L'I' YES <br />� NO <br />MECHANICAL <br />PLUM8ING TVPE OF ENENGV <br />❑t7A5 ❑ELEC. <br />. _ ___".. _.._... __'_ <br />. � NO. TYPE OF E�UIPMENT � FEE <br />AIF COND. UNITS-�LV. EA. -+5 I <br />NO. TVPE OF FIXTUPE OR ITEM FEE qKqIGERnTION UN��S n v. En. �--t- <br />--1— <br />HAIHTIIU$ $ -- -pOIIERS HP.EA-"--'-�""_--_"-_- � . <br />CIOfHES YlASHEN � . - - ' '-' ' ' - � "-',-'-T'� <br />UISH VJ15HE�15 i _ FORCED AIR 5�'STEh15 8.T_U: MEA. � <br />_L__ I <br />DFiINY.ING FUL'DJl'AINS I I --' '"—.- -""-' --- I <br />FIDON pHAINS � SPp.CE & WALI MEATERS - fl.T.U. _� <br />.__' <br />KITCHhN $INKS & DISP. � UNIT 11EATER$ H.T.U. ___ I <br />lil1H SINY.$ � EVnPOHniIVE COOLEHS -T— <br />NOOF DRAINS RAIN LEAU[HS 1 <br />� CLOTMESORYERS .....---'----I-_" I <br />SHOR'ER E7ATH5 VENTI�ATION f AN �— <br />.'iLHVICE $INKS qANGE HOGD � <br />SUh1P5 .-. SEWAGB PUMP '------'----- <br />Ufi�NAL$ � Alfl Ml�NDIINC UNIT _. ._... C.1'.M. � <br />__..�___"__"_._ ...__.._..�..!"'."'�.�_ <br />tvnter� r.�osf;.is �- . .._.._ ..__ . . . _ .__.__. .... ._. . � <br />... ._ _....--- <br />- '-'-'� -' - -' WATER NEATEq �� T <br />WATEfl NEATEHS - ELECTRIC � ..._ _. _._ . __" '_'_. . ._r .. _ _.��_ <br />—____ <br />WASH DASINS ' i fAC. eUtLT FIREPLFCE I4 CNIIdNEV � I <br />_'_ _ . ' . ' —' _ <br />__. _... ._.._______._� ". _.__T__ <br />LAUNDflV TFlAYS . - _ GAS. S�STEM:_NO OP OUTLI IS . _ � <br />UO TOMI $� I <br />� � - -_- �� -'- PERMIT 5 _r-- <br />— - 1 _-- "- � ^TOTAL FEF 5 I <br />SU� TO7AL � -- � - --- - -- -� <br />PERh1iT S 7���� NF.11nnIT LIECOME$ NUI 1. nN�) VOIO If WU11Y, OH I:UN$Tf:VC I <br />TOTAL FEE TIpN AVf110(i12ED I$ NO1 CO>A41lNCEO IViTHin1 1?0 C��'.. Ofi F <br />CUNSTHUC�IpN Ofi \VOHK I^ SU::P[NDED O11 Af{l�WDC`1ED FpF �A) <br />VJATER $EHVICG SIZF. BLDG. $UPPLY `.iIZE ✓EnIOD OF 170 �nYS AT nNY f�M6 nF iCN W(1nK �SC.•S�!.1ENCEC � <br />w�eaw�� e�e.e�.� ���W I R(Rh11Y CEIITIFY THAT I IIAVC IiEAD Aldf) E`�A6�INID fN15'��� <br />�i�r Y�h L A � i i btltln(,K IitAHYAHUSEiUACKi pL�CATICIN i.ND KNOW THl 5AA1E TOI:I T(IVE •WUC(`��iiEf_L A��! <br />VROVI`iION: OF I.AIV$ ANU OIIDINANCF.ti GUVERN�thG T�US TYPEi <br />OF WOHK YlILL BE COM1IPL�EU WII1/ W��EIHEN ::PECIFi.O N[�IEIVI <br />U::! 7UNk lUT AHIA VACANT SR6 T- Ofi NOT, T116 GRnN71NG OF A PEfi�11T DOC!. NOT PFESUME TO' <br />(iIVE AUTIIppITY TO VIOIAfF. ON CANChI TI�E Nn'1ViSIqIJ$ OFI <br />' ❑YE$ ❑NO I ANY OT��@R STATE O11 LOCAL L4W HLGULAt�N<i C`M.:TIWCTION <br />TYFE bF CONST. OCCUPANCV (:ROUY N0.0F DWFLUNG �R /T�ME PERFOfiMANCE O� CONSTHVCTION. <br />— _ UNITS I I , i / /�� � " , n � �. . <br />—j..-.—"-' �____'___.__.�SIGfOhTU(ICOPCONTRACTOfiOR(1lfTN.AiiEN <br />$PEC�AL CONDITIONS: <br />� <br />' '_�...._._.__.. _...'_. __... __ <br />❑n0 _ �tC InECEirTN�� <br />. . �—�—_FEES ..Y.. <br />� �� . dUILDING <br />--_ I __ '. ___ <br />SEPA REV(EW COMPLETE � ❑YES 0 NO ' rii�Mnir+r, <br />� _.._ .. <br />i conlocf planninq dOP�. MCCIIANICAI <br />i <br />, ' <br />' OTMER <br />♦MlIUf1UN�CLlI1lUYV' +lANSCrIIAIUYY' AMNpV10/OMISA�MC�YT � PENALTV <br />� ' ' __.__' _ <br />TOTAL <br />_ _� —' �_r—' <br />I <br />__— _ ___1 �'_ <br />S � <br />I <br />. ..._--------- — �----�r-- <br />i <br />i <br />i <br />. i <br />_ �__. <br />� <br />$EC. J071�1 � <br />' ""_ "_' ' _' ' _' . _.. l__ <br />— 1 <br />0 <br />