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PERMIT APPLICATION" <br />BUILDING <br />MECHANICAL PLUMBING <br />UVJIIL'll MAIL AUDHLSS ZIP 11HUNk <br />Na,.,c!R /T -e e v re'3 S s- ff6 4 <br />IICHITECT OR DE516NER MAILADORESS 1'IONE ICE SE NU. <br />OENERALCONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />MLCHANICALCONTRACTOR MAILAODRESS PHONE LICENSE NO. <br />4 i J <br />!�! <br />- <br />PLUMVIB10 FOUTHAGIGIR AIL ADDRESS PHONE LICENSE HO. <br />fie. <br />I <br />CLASS OE Fy�WORK , <br />NUMBER OF STORIES <br />S <br />Q/ UILDINO ❑PLUMBING ❑MECHANICAL <br />4I <br />BASMENT <br />19NEW ❑ADDITION, ❑ALTERATION ❑REPAIR <br />VALUATION OF WORK Ii. <br />0DEMOLI511 ❑FENCE ❑SIGN []SWIMMING POOL <br />f <br />/e, �.�' <br />DESCRIBE WORK <br />, <br />{I <br />Pf10Y CD USE <br />• <br />LtGAI DI.SCArrTION O HOPCPTY ISI OW IIELOW On ATTACH <br />POun coms1 <br />LOT. BLOCK -OF <br />JOB AUDnCSS <br />zo l9 7 <br />PLUMBING <br />MECHANICAL <br />T.YPC OF FUEL DUFL NAT. LPG. PLOT PLAN <br />- <br />GAS <br />NO. TYPE OFECUIPI.IENT Draw plot plan <br />F NO. TYPE OF FIXTURE OR ITEM <br />AIR CONO. UNITS-H.P. VA. <br />on back side. <br />WATER CLOSET ITOILETI <br />R Er RICC11l.T ION UNITS-1/.P. EA. <br />BATHTU6 <br />nDtLERS-11.1'. EA. <br />_ LAVAT: Rr (WASH BASIN) <br />OAS 1`I11ED A.C. 11NI7S-TONNAGE EA. <br />_ SI101tE4 <br />1'I TCNf'. s�NK b OISP, <br />FORCED A111 SYSTEMS-O.T.U. M CA.. <br />_ <br />OITc4f% EN <br />WALL HEATERS-B.T.U. M <br />_ <br />LAURO;r TRAY <br />UNIT HEATERS-O.T.U. M <br />_ <br />CLO_T�E541'A511ER <br />EVAPOnATIVE COOLEnS •. <br />_ <br />WATER If ATCH <br />CLOTHLS Grimm <br />URINAL <br />VENTILATION FAN <br />- DnINKI%3 FOUNTAIN <br />nANGE HOOD <br />_ FLOOv-F;%K On DRAIN <br />Ain HANUL ING UNIT- C.F.M. <br />VACUc."SRCAK C nS <br />ROOF C•AIA5-(tAINLEAGEnS <br />INCINCHATOn <br />—� SINK ISIRVICE-BAR, ETC.) <br />�{ _ <br />._....... ... <br />ITTV•jf�T` 0. T,Y BELOW <br />- <br />_ <br />SIDE r'AItU bLidACK SI RELT 6ETUACK <br />:., <br />IICAR YARD SETOACK //� ' <br />• <br />ISEZONE LOT AR EA <br />VACANT SITE SI Al Ullf: Or N'nA ton nAUTIL AOIiNI�DAT <br />_�. <br />• <br />❑YCS []NO ' FEES ^ <br />-TYPE OF CONST. OCCUPANCY GHOUP <br />uN;OSI OWCLLIN71� PLAN CK - •CD VALUATION <br />DLDG PMT 0 <br />SI L' or BLDG. NO. OF S7011ILS <br />MAX. OCC. LOAD MECIi PM c.) PLAN CK NO7(y-50 <br />Z <br />PLBG PMT <br />_ <br />IILRONE BASEMENT <br />TIIT.PIIINK -A , <br />TOTAL <br />w uuHH 0 <br />