1986, 09-29 Permit: 00013333 FurnaceSIGNATURE OF ' APPLICATION
OWNER OR.AGENT DATE
JOB ADDRESS
• .yi (' .L F I L7 S I S (E M t
FI -.(i SYSTLM iBrU) t
OIL WUIJRGE: F-•"Iec;t
K'3lRIEJFI0N; Fore:
ME»CHANICAL.. PERMIT
PROJECo
5E0. 0:
DATE:
FEES:
$27.00
PAID BY:
G
COUNTER APP:
PLANS EXAM:
DATE:
TOTAL FEE
Quantity 01 Fee
1(10K or Less 01 Over 10UK 0 Fee
ric N Gas Y Oil. N Coal N Wand N Solar N
ed Air Y Radiant N Haat Pump N
INSPECTOR'S COPY
Processing Fee
$P7,00
00
3.00
9.00
15.00
•
OWNER:
ADDRESS:
CITY: 5T: ZIP:
APPLICANT:
CONTRACTOR:
11AV11)
ADORE55:
5Fill! l -r/ RD
CITY: ST: ZIP:
(.!.1 6
PR: LICENSE.:
ARCM/ENGINEER:
ADDRESS:
CITY: 5T: ZIP:
PARCEL=: 'CENSUS TR:
INSPECTOR:
PLATS;
LOT A,( 0500K
FINAL
PLAT NAME:
1'4( i • I-;1. P
ZONE.:
ZONE
558
5-1
9-Z
R519
MOO
I:. P i.P ING(CHANI E:, -OUT )
USE OF PERMIT:
JOB ADDRESS:
RI)
R xlIL
• .yi (' .L F I L7 S I S (E M t
FI -.(i SYSTLM iBrU) t
OIL WUIJRGE: F-•"Iec;t
K'3lRIEJFI0N; Fore:
ME»CHANICAL.. PERMIT
PROJECo
5E0. 0:
DATE:
FEES:
$27.00
PAID BY:
G
COUNTER APP:
PLANS EXAM:
DATE:
TOTAL FEE
Quantity 01 Fee
1(10K or Less 01 Over 10UK 0 Fee
ric N Gas Y Oil. N Coal N Wand N Solar N
ed Air Y Radiant N Haat Pump N
INSPECTOR'S COPY
Processing Fee
$P7,00
00
3.00
9.00
15.00
•
•
INSP-IDV
r!'�/.i,
DATE
t -I347 5-4fil 74L1 4
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JECT FINAL