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- CONSTRlJCTION �r/%/'' � <br />PERMIT APPLI�ATiO�I �j �� � <br />COIVIBINATION • BUILDING • MECHANICAL • PLUMBING <br />r <br />!� <br />❑COM9I!:ATION � <br />❑ OUILDING ❑ PLUMOING ❑ MECHANICAL <br />LOT <br />PLUM�ING <br />iIPTl01 <br />i <br />BLOCK <br />TEFi SF.RVICE <br />U.^.L. 'f.UNk <br />SPGCIALCONOITIONS: <br />� <br />OF _ <br />aooH <br />�� <br />r�� <br />+' '- /: % <br />VSE NU <br />•��' ' C 3 -' GO <br />VtiE NV. <br />i r <br />ADORE55 PHONE LICENSE NU. <br />SSOFIYOFK • --'— -�— <br />❑NEW �ADDITIUN �AL1'E11/�fl(IN ❑1�[I'N(1 <br />❑�E610LISH ❑FENCE ❑SIGN ❑:IVIhIMIN(1 YOOL <br />� OTHER PERMITS OR APPROVAl5 <br />� REZONE �j SPECIAL USE <br />TTACH <br /># VARIANCE �{ SF'.ORLINE <br />5 E PA CHECK LIST P.Ec�UIRED <br />I� YES <br />Sj NO <br />� , �, �� .�; � � � � MECHANICAL <br />� TYVE OF ENEPGY <br />Ur.ns Oe�ec. <br />. NO. TVPEOFE�UIPMENT � ` FEE <br />—'_ __. __ . .... _""_ .._'--_ <br />AIRCOND.UNITS-F�.P.EA. S I <br />ITEM FEE � REFRIIiEN/1TInN VNi f: II V. EA. --� <br />5 ' '__ � _ `_�__� � <br />70R ER$ H.P. EA. -"" "—"'�" "� -' 1 <br />� . .. __ . .. _— __�-T <br />FORCED AIR S�STEM� (t.T.U. MEA. i <br />� _ _..._'_—. _"_.... "___' L _ <br />i' . _'—".' __""' ___ {I � <br />$PACE 91 WAL� HEATEH$ �- H.T.U. I r— <br />I _ _� �}��__ <br />� UNITIIEATER."i N.T.V.___ I 1 <br />� EVAPOHnTIVECOOLEHS - --i— <br />3(iS � CLOTIIES ORVERS "'...'----"'—'�—"" I <br />VENTILATIONFAN � �— <br />! <br />RANGEHO00 . I I <br />_'__ __'.. <br />� AIH lIANDLIN(: UNIT C.�.M. ___.y_� <br />'_""'___"_ "_._... _. _ .._... _....__. `._. � <br />1 _� ._ . ...."_"' ._"' "_ . . . _ ._..._ .( <br />C � WATER NEATER . . I�^_-�— <br />� �— FAC. BVILT FIREPLACE 14 CH V.INEV -r— �- I <br />� GAS.SYSTEM:.NOOPOVTU�.I$ �I—� �_ <br />' '._ _ ....SUfI TOML 5 I <br />__ _ i ' _ _ _ ' PER'NIT ._S '_'"'""' _'�.__ <br />_. ___ _"_'"'_'__.. .'__ <br />� TOTALFEE 5 I <br />,L � THIS YF.fi611T OECOMES NUI l nND VQIU II N'UIIK 11q CUNSTRUC <br />5 TION AV(110RIYED IS NOT CU`dA1lNCED WIT111N 1?0 UAYi, OR IF <br />�E �—� CONSTRVCiIpN OA WOfiK I:f iU:i�`fNOEO OR A(3nND0.':[O Fpq A <br />BLDG. SUPPLY SIZ.F N��IOU oF 1Y0 DAYS /�T nNv IIMG AhTEH WOfiK �.': CP•dLtENCEU. <br />7ACY. NhAHYAHOSETOACK ���EREOY CEfiTIFY i11AT 1 1�/1VF. HEAf) Al.n EYI�AIINlD i1�15 AP. <br />PLICATION AND KNOY! THE :A� E TO Iil TRUE AND CORf1E�.CL ALL <br />PROVISIONS OF LAWS ANU OItO1NANCES GOVEfi4�NG THIS TVPE <br />OF WONK WILL BE CO�APLIEU VVI711 WHETHFR ::P[CIFIEO H[REIN <br />VACANT :ITL � OR NOT, THE [iflAN71NG OF A PEFh11T DOE`.i NOT PRESUtdE TO <br />GIVE AUTHORITY TO VIOIAfE ON CANCtI TME NRUVISIONS OF <br />❑VES ❑NO , ANY OTM[R STATE OR LOCAL I.MV IIL(iVLl1TIN(i CONtiTI1VCTION <br />GfiOUP NO.OF DWELLIN(: Ofl TNE PERFOFMANCE Of CQNSTHUClIqN. <br />UNIiS / � <br />JES MA%, pCC. LOAD f��/� � G' �j � � <br />Xl � 1 _2�.��L�.—,���_ /�—/' 7 7 <br />f11iL'i'111NKI.LN.S �IG��OFCONTRACTqflOH11UTM.AGE�lT DATE <br />REOUIHEU 1 LAN CHhCK NUMUtH NLAN Clill'K 4EL <br />❑YE6 ❑NO I f f:L �IIECEIPT Nfl. <br />SEPA REVIEW COMPLETE � <br />confacf planninq depf. <br />L7YES � NO <br />FE <br />EIUIIDING — <br />ri�irnmr+r, .. <br />n+cr_��nNicnt <br />on�en <br />"PlIU11UNACL111lUYV. YUN]CrylCF�OYY: AMfl0Y10 U11L4.UAMGfYY PENALTV <br />� � __—. <br />� <br />TOTAL <br />._ ... .. .. . . . .. . ... . _ <br />VALUATION F[E <br />___--' __."'.r_. <br />I <br />/� � __.. . _'—�_ 1—_ <br />_ S/V OQi% J` �i� <br />/---�--- -- — •— -- r-- <br />i <br />_.._ � <br />. i <br />. ._ . �.. _. .. <br />� <br />i <br />---r-- <br />$EC.7071�1 � <br />_ _..__..."__ ' _ __—"'.. L__ <br />t <br />