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<br /> cin� i�n��zs�o%n, . BUILDIIVG + McCHANiCAL • PLUIuIBING
<br /> �_�,F�zF��, �vn oa:�o� COMBINATION
<br /> t.tAll_l�UDHE:iS --.. LIP PriUNE �
<br /> _ ,.- 1 . �.. 11 i 1'; � 1::'":. r� •V ._". .�'_ , � �_. . � . ...,', ' ' ^ ^; � .,'�_li/�•.i �,_ Jm.7
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<br /> $df?i? H6 ��'lOVO _ — - .
<br /> CCFNERAL WNTRACTOR
<br /> Iv1AIL ADOIiE55 . P���ONE ;.�CEfti51[ '�:� . 7�
<br /> Sn��ne as oorner :;II–L::–S',1•-?4�G1� �
<br /> PHUNE LICENSE NO.
<br /> MFCHl�NICAICONTRACTOP � Mn�L,PD�][�6SSn',e. I.�w J• _ m
<br /> 1 / /1�
<br /> + �9"�-(1?'�-;�'�:� 7J
<br /> ';Cl13b10 .i�'1^_G'� i�iC'.{]11 �r ' r�-l �n oo.(1'i'� , -L,.Qi1..�
<br /> PWMfIINGCONTRACTOR MAL},r�U��SS NHO�'E LICENSENO
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<br /> ';'_' . : F1�:�:'. r.� �� „ � . ��"�, .�.��.���
<br /> FEhM1T �' " CLnS OFVJORY.
<br /> ❑COM6INATION
<br /> [] pU1LDING ❑ NLUMBING ❑M[CHANIC/�LI �N�W ��.pDITIOIJ ❑�1LTEHnT10N ❑FEV.�IH
<br /> — — _ -.
<br /> V�:LUATION OF WOfiK rSWIMASING POOI.
<br /> � �: �.� J.��) ❑pEM01ISH ❑�ENCF ❑S�GN
<br /> �ESCRIBE WORK � �
<br /> ��.t171C� Yl.-•�:1 �.'..'1"'1_(' ' ' _'.il ,: ."L'�]_C1a�I1Ci�
<br />� vaoroseo use. MECHANICAL
<br /> '.In�.r �ln".1;'' iVP[ OF NEH6Y --�-
<br /> TT;.CII C]f,A ❑EIEC.
<br /> LEGAL OESCRIPTION OP VftOPERTY IS�+pW 6EL0�4 Ofi A ' --- FEE
<br /> FovRCpPiEsl ��,llj.;�, . -.'J:l :��.�„�n'-- NO. TVPEOFEaUIPMENT _ --
<br />�I / _.. _._ . _. .. _ 5 �
<br /> �_p7 �LOCK—aF -- NF l'"]NU. UNITS -11 P. EA _ _ _
<br />/ .. ��REFItIGERI�TION UNITS IIP. EA.
<br /> r _ ... �OOILENS II.P. EA. —� �
<br /> � I FOFCED AIR S�STEMS-B.T.U. MEA. - -
<br /> ' ___—__-- I
<br /> I �—
<br /> _.. _ _.. ___'__ . . .__--'
<br /> -- �� '. SPACE K WALL HEATERS - B.T.U.
<br /> J06 ADDFESS �- -� -— 1
<br /> �!j�) [{�.Il �'.VE'. � ..� . �,UNITHEl1T[R$ 13.T.U.__ _
<br /> . iEVAPORATIVECOOIERS
<br /> PLUMBING .._ ] ic�on+csor�vens _ _ 3100
<br /> ---'- ---� � � VLNTILATION FAfJ �—�
<br /> ] RnNGE n000 -� --T—
<br /> - F [ -- _ � AIR HANDLING UNIT- C.F.M.
<br /> NO.� T�PE OF FIXTURE OR ITEM �T,c.-� _ _ _ _-___-.-- �
<br /> F3ATH iU85 i � i� _ . ._. _..-_'_.-'—_---- T—_
<br /> � CLOT4ES WA S H E N _ w A T E1i N'cATEq___ _ _ -. . J-
<br /> '"T' __
<br /> DISH W�ISHEHS �- - FAG BUI�T fIREPLACE R CHIMNF.Y _j� .
<br /> � DNINKING FOUNTAINS � GAS SVSTEM NO �P UUTLETS � ._
<br /> � ____ __ -�_ 1
<br /> _-_ —
<br /> �LOON DIllUNS �I-�ll _.. .. __ — U[�TOTnI 5 � I 1(1 _
<br /> KRCHEN SINKS & DISP. ' PERMIT $ �
<br /> E3Af751NK5 �—T �-----� TUTnI �EE 5 �� ����1_
<br /> ROOP DRAINS HAIN LEADERS � ... -_ ---- ----
<br /> I $HOWER HAiHS _ % 1 THIS �'fiftMlT BECOMLS NULL [1t�P VOID IF WORK OR CONSTHUC
<br /> _ � 11ON AU�HOfiIZLfJ �5 �JUT COMMEN�_flD WITNIPI 120 O�Yi. UR If
<br /> SERVICE SINRS CONSTRUCt1UN (>P WU�iR IS SUSPEfJDFD Ofl 11RANDON.fG Fi)H �
<br /> SUMNS �- SE`1Jl�GF PUMP ; — PEniOD oF 120 Dnv; ni ��NV TIM[ nFiEt1 wOfiK �5 Co�V�MENCED.
<br /> UHINALS -- 1 � ���� 1 R[l4EfiV C[RTIFV TI!nT I IIAVE NF.AD l�NU E%�1h11NiD TNIS �\P
<br /> WATFR CLOSETS __ . � FLICATION I�NO KNOW 1NF. SPM[ TO RE TLWE AND CJP.FECT. /�LL
<br /> � WnTE(i HEAT[RS - ELECTFIC - � P�ovisioNs oF �nws nNu or+ownNces �ovef�Ni^rs Tiiis '�'�'E
<br /> WASH 9ASIN$ --r- (- � OP WOfiK WILL f3[ COM11P1 IEO WITH WHETHER SP£GFIF.O FiENE�N
<br /> — O�i NOT, THE GfiANTING OF A HE��MIT C)OES NOT PP:SC'.A[ TO
<br /> �- LAUNDRYTRAYS ___ � GNL nUTU(1RITY TU VIOI-l�TE Ofi CnNCFdL T11E Pl�ti'l�SIbN: OF
<br /> liNV t�IHF`ii ';T�TL OH LUCAL LAW fi[GUT ATINL' GLla3CRUCTiON
<br /> �_ -� I r)R ilU� PI�.HrnnAlnNr� .1: (11' �nhSrfauGllON
<br /> _ — � �
<br /> --...-- SU6 TOTAL --- •. � ll�.i � 9J �y
<br /> ' PERMIT 5. ___,_�� ! '/S-'/
<br /> � TOTAL FEE $ ' �r,._ , . - .___ ._ ._ _ . �—_
<br /> � ivnfuii�: n����.uN�i+ncTu � ti uni.nceur onTt
<br /> WF�TER SFRVICE SIZE BIDG. SUPPLV SIZE rLnN cN[cK FEE
<br /> SIDh YARI];ET[lACK :;l RELT iETRl�CK ilf nR VARnSETIlAC . PLl1N GIIECK NUMBCR rL q�CEIPT NO.
<br /> 7r��
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<br /> —-- LOl nRL/� �- - Vl�CAM `:RE
<br /> USL 7-ONE � �
<br /> mvES ❑No ___-. _.__ FEES — — FEE
<br /> VALUATION
<br /> 1;-�. __ . ___. _ -. __ —�_—
<br /> TVPEOFCONST OCCUYANCYGROUP NO.OFDWELLWC� �
<br /> UNITS � __-__. .-_ _ -'_.—
<br /> aQi�f �]-t-� � - _ �_._ �
<br /> :tUll_�ING 5 �i� 1��J.�)i) 1.2�1 I(�,'''; ,
<br /> SRL OF 6LDG. ND.OF STORIGS MA%. OCC. LOAG �-----
<br /> �O',�,4A `;;'�] i 'C. P�_VM6ING � � AY� ��11; _ �
<br /> : ...� _ . . . . 7 �
<br /> FIIqF. 20NE 0l�SEMLNT --� FIH65P.'iINKl.C41:. _ ':- ---- (D
<br /> q�UIflEI: �N '1[CHANICAL l •1 H�� ����] _
<br /> I�C LJ �� _.-
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<br /> iPfC1ALCOKDIfIONS�. --'__ OTM[R � I
<br /> ___._ _ __ � _.. _._
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<br /> _'_ _
<br /> j i O'I'. �'!'ynClY ^EC. 9091a1
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<br /> . -._...___—— ___—___.-__ ___-_______._.—_ _-_.. . �
<br /> ._ _._ - .__'_ '_--..
<br /> _ -'_- '__. �iOTAL 1 :�.'; �i)O
<br /> - -_---- '-- � PLRM1IITVALIDATION A�C��; y � ��,� 6 nT
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