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; .PPLICA,TION F��,.-' <br />IM Er�rpnen L p N S T IY U C T I U+ N <br />�,� o. <br />everet� PERMIT <br />BUILDING DEPAPTb1ENi <br />259-8745 TO BE COMPLETED IN INK • PLEASE PRINT <br />evcretl <br />�i <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDIN6 n MECHANICAL O PIUMBINO ,� 31GN <br />')WNER ME4�M�f94 CIIV _--1�� ����Nf j_ � S'� y <br />'IQ�r�rtC �i�i�c �L_.�-ss � 'r�l37o S're.4.�ar_i rr_,S; ,u._�,�� u�n� 98ic, <br />�neerteeionoreimrtn M+n�nemaa cm ��r nior�t <br />SI�N T�':L�,... _iu ��o�i U:rri«/il�i� .�$�'N -C'::- �C�/'i�77CCC41��i!I//j S7 %-�)�t J� <br />1 <br />�r��EMlLn111O�C10N M�IIApOII[.9 Gh lIP PI�OHC '.ICCHGE• <br />� ( 1 �� �i .Ck+ .f�"i.-.(CP lf)C%<T�(J J'. <br />!ECr1��L L C'ONiR��� ��M�il �UL E99 �C �� � 1� CI�Y I�P Pn0 i! [ t�� f.H!.f • <br />./ 1 � �� � I �` � ��� �/\ <br />'IUMB�NOCON11Udp11 M/iL�OU�[59 -� C�tY lIP OUONE '.iCE14!• <br />NEW ❑ �DUIiION ❑ AU[RATION ❑ H9PAIFl ❑ OEMOLItION ❑ WCOOSfOVE/FRPL.INSERT ❑ BUILDINO R[lOf,qTION <br />. nnu nr w.^.ne iron� or MUr nu� •, rlus l�eOrp <br />f4C��Bi <br />�r��sc�o.c. <br />t011E <br />u <br />N�n <br />�, � <br />1 HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS AP� <br />PLICATION ANU K NOW TIIE SAME TO BE TiiUE ANDCORRECT. ALL <br />PROVISIONFi OF LAWSAND ORDINANCES OOVERN�NG THISTVPE <br />OF \YOqK WILL BE COMPLETED WITIi WNETf1EF SPECIFIFD I1ERE• <br />IN OR NOT. TfiF GRANTINOOF A PERMIT DOES NOi PRESUME i0 <br />GIVE AU7HOFITY TO VIOLATF OR Cf�NCEL iHE PROVISIONS OF <br />ANV OiHER STATE OR LOCAL LAW R[GULAT�NO CONSTRUCTIUN <br />OR TNE PERFORMANCE OF CONSTRUCiION. <br />sior+erua[ey:ontnecryrreyuurr�anizeoncera onie <br />,� �% /�' <br />(x iJn"'C (.�-� "c— S - / 9 -? 7 <br />�PPIII:�N�S CIIY pU5WE59 Uff N9[ NJ <br />�3 3�as <br />AIq COND UNITS—N P. E� <br />REfPIGERAIION UNITS—N f. <br />fiOILERS-11P. ER. <br />OAS fIf1ED � C UNII9—iON� <br />fORCEO AiR S�S1EM5—B.T.0 <br />WAILHEIIIERS—B.L❑. M <br />TOTAL FEE 11 _J�__j _ �uu� rce a I <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />U� Si Wu[9 <br />rq.r.el0 Or <br />V�f.�Nl SIIE <br />f1vE9 :1N0 <br />NO Of p.VEI <br />M�F <br />r[[ nt�[ir�Ho <br />r[[a v�tu�noH rcE <br />NO Wu13 <br />emiou+a s <br />� — <br />flUM01N� <br />MELIUNIGI <br />ot:�, n <br />PEN�LIY <br />iui�P+ _ _ _ ---_ <br />��L�c', . Tor�� <br />� ��� --- ------ ----- - <br />. <br />�, �� I <br />i ; <br />�, ,�,�, ,�-J <br />