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. . .. .. MAI'LADDRl;S5 ZIP RHONE.
<br /> Richard D ' 9311., 3rd Place 355-9130.
<br /> "ARCHITECT OR bF.S'GNB MAIL ADDRESS PHONE r.ICFNSF'NO •
<br /> GENERAL CONTRACTO.R•' • MAIL ADDRESS PHONE LICENSE NO.
<br /> Same .
<br /> : MECHANICAL:CONTR'ACTOR: MAIL ADDRESS PHONE LICENSE NO. •
<br /> 'PLUMBING CONTRACTOR' - MAIL ADDRESS PHONE LICENSE NO-
<br /> PE RMI'T" —
<br /> �CCASS'OF WORK ,i.
<br /> Q COMBINATION'
<br /> QIBUTA.DI:NG [3,PLUMBING QIMECHANICAL •
<br /> ' • • • • , Q
<br /> •`: . . :NEW' QADOITION 0ALTE'RATION • ®KEPAIR
<br /> VAI UAT,IO,N OF WORK .. .
<br /> (, ' $ 200.00 Q'DEMOLISH' QFENCE ;QSIGN ,QSWIMM'ING POOL
<br /> I, DESCRIBE.:WORK
<br /> impair:wa3k ,way replace.. rotted' materiel .
<br /> I. PROPOSED USE s
<br /> MECNANI�AL
<br /> #14i420. family: residence TYPE.OF ENERGY
<br /> LEGA LOESCRJPTIONOF'PROPERTY ISHOW BELOW OR,ATTACH. '• QG'AS QELEC.
<br /> FOUR P.YES) •
<br /> 4 a.2' Ci•.' ' Land'Co. . S 1s No. . TYPE of EQUIPMENT FEE`
<br /> • LOT BLOCK,_OF �
<br /> ,'.,?!'!•"••,,,•',:,,,,,i,,.',:-::,..:'••••:„.....,i _
<br /> AIR'COND:UNiT.S" H.P..EA.• ' .k
<br /> "r : !' .: .REFyRIGERATION UNITS-:.H.P. EA..
<br /> •� i I,, .. BOILERS-H'.P.EA. " :'.}.
<br /> ., .. �, . FORCED A'IR'•SYSTEMS-B.T:U.. MEA'. ,
<br /> •JGB ADDRESS • `'SPACE &WALL HEATERS- B.T,U, '
<br /> 4018 Hoyt " UNIT HEATERS--B.T.V. I''.
<br /> �EV
<br /> �_ APORATIVE;COOLERS
<br /> c -
<br /> PLIM�B�NIa` • CLOTHES DR YERS:
<br /> 1:
<br /> VENTILATION FAN
<br /> _
<br /> I%YID : • NO'. TYPE.OF RANGE HOOD'
<br /> 1
<br /> 1
<br /> OF FIXTURE OR;ITEM: 'FEE . '•AIR HANDLING UNIT- C.F.-M.' • 1
<br /> v •CLOTHES WASHER • I .•.1 - I
<br /> DISH WASHERS - WATER HE4TER. 1=
<br /> I;..; ...:,DRINKING MINS 1. FACBUILT'PIREPLA'CE`& CHIMNEY'
<br /> .DRAINS i F--
<br /> +. •
<br /> • • .'KITCHEN:SINKS a'DISP. 1 GA SUB TOT S ,V:
<br /> S SYSTEM:•NO OP OUT
<br /> •
<br /> AG
<br /> ��', i • 1__, _PERMIT $ :
<br /> `ROOF^DRAINS RAIN LEADERS ••.
<br /> SHOWER'BATHS THIS PERMIT BECOMES NULL AND VOID IF WORK,OR CONST•
<br /> SERVICE SINKS • I • .-PION'AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS;:0
<br /> I SUfllll*S'^SEyyAGE,PUMP 1• CONSTRUCTION OR WORK IS.SUSPENDED OR ABANDONED Ff
<br /> �. a'' I"
<br /> ,. ,tlRINALS ..; „ 1.
<br /> PERIOD O�F'�:120 DAVS'.AT•ANY TIME AFTER WORK:IS COMMEN"
<br /> I ' ',..MIATEA.CLOSETS •• . ' • • .: : • 1 HEREBY CERTIFY THAT •SAME.READ"AND'EXAMINED TN1;
<br /> .WATER'HEATERS:.-•ELECTRIC 1. PLICATION AND LAWS•AHE•SAME TO BE TRUE AND C')RRECTi
<br /> • • PROVISIONS OF LAWS•AICD ORDINANCES.GOVERNING THIS 1
<br /> ;'WASH''BASINS 1 :OF :WORK.WILL BE COMPLIED WITH,WHETH:E.R:SPECIFIED':HEI
<br /> ... LAUNDRY.`TRiAYS : : OR:NOT,.THE.;GRANTING OF.A ,PERMIT DOE NOT:.PRESUME
<br /> • • •GIVE.AUTHORITY TO VIOLATE,OR 51:::4.21-A•
<br /> ANCL' THE PROVISION:
<br /> � • ANY OTHER'STATEOR LOCAL LAW REGULATINGCONSTRUCJ
<br /> 1 ORTHE PERfORMANCE OF.CONST'RUCTI'ON"
<br /> PERMIT' ' S 1.
<br /> TOTAL FEE I 8/2.6/7
<br /> MA4^TER SERV ICE SIZE BLDG.'SU SIZE SIG .,uRE OF TRACT R•AUTH:AGENT ', DATE
<br /> SIDE.YARDSETBACK' STREET:SETBACK AR'YARDSETBACK PLbCHECK.I BER•. .• ' . . , PLAN CHECK•FE.E '
<br /> FEE RECEIPT NO..
<br /> USE:ZONE LOTcAREA ' . _ VACANT SITE
<br /> DYES Q.
<br /> NO: FEES VALUATION FEE
<br /> PE OF CONST: .: OCCUPANC.Y GROUP' NO.OF DWELLING. - 1
<br /> TY
<br /> UNITSC •
<br /> I,
<br /> SIZE OF BLDG NO.OF STORIES MAX.OCC. LOAD BUILDING $• 200..O.0 �_S (
<br /> . • •
<br /> 1
<br /> PLUMBING
<br /> FIRE ZONE BASEMENT FIRESPRINKLERS. •1
<br /> REQUIRED •
<br /> 1'
<br /> •
<br /> •
<br /> SPECIAL CONDITIONS
<br /> DYES. QND• • MECHANCCAL
<br /> `OTHER ) ,
<br /> PENALTY SEC.303(a1 I ,
<br /> TOTAL.' I
<br /> PERMIT:VALIDATION' '
<br /> • WHEN PROPERL VW
<br /> ATED IINTISS:PACELTHISISY, R
<br /> .. .\
<br />
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