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thr EverRreen C(�ySTR U CTION <br /> CITv Of <br /> everett PERMIT PERMIT NO. O74Z5 <br /> CITY HALL 25&8745 <br /> eveaerr wn sazoi G COMBINATION � BUILDING ❑ MECHAMCAL ❑ PLUMBING <br /> OWN R MAILA SS CITY liV PNON <br /> John H. Dwyer 2109 Adams _ <br /> 4flGHITEClORDlSIGNER MAiLAUDRESS C�v ZIP PHONE <br /> GENEPAI CANTRAC�OR MRIL 40DRE55 CITY ZIL PHONE LICENSE I <br /> MECHANMAL CONTPACTOR MNIL NDDRESS CITY ZIP PIIONE LiCENSF Y <br /> PWMBMGCANTRACTOR MAILADDflES$ CITY ZIP VHONE UCENSEI <br /> GUSS OF WOFK <br /> ❑NEW XEADDITION ❑P.LTERATION ❑REPAIfl ❑DEMOLITION ❑FENCE ❑SIGN ❑GAR�IGE <br /> VALUATIJN OF WOPN <br /> S 5,500.00 <br /> DcSCRIBE WOPN <br /> Addition to existing residence <br /> PROPOSED USE OF BWL�ING <br /> sin le famil residence I HEREBY CER7IFY THAT I HAVE REAC�AND EXAMINED THIS AP- <br /> �ece�oescairnonocvaoaeATrtsNowae�owoannneNwuacoviesi PLICATION AND KNOW THE SAME TC BE TRUE AND COP'.iECT. <br /> 5-26-2 21 Pinehurst Div. B ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING 7HIS <br /> �o�t �LOCK�OF TYPE OF WORK WILL BE COMFIIED WITH WHETHER SPEGFIED <br /> HEREIN OR NOT. THE GRANTIN6 OF A PERMIT OOES NOT <br /> PRESUME TO GIVE AUTHORITY TO ViOLATE OR CANCEL THE PRO- <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE PERFORMANCE 0 CONSTRUCTION. <br /> SIGNATUR[ NTR TOR OR qUTH ED RGENT OAtE <br /> JOB ADDRE55 <br /> 2109 Adams Street X �� � <br /> PLUMBINO ME t7�CA <br /> NO. TYPE OF FIXTURE OR ITEM FEE N TYPE OF EOU PMENT FEE <br /> WATER CLOSET QOILET) AIF GON�.UNITS—N.R EA. <br /> BATHTUB REFRIGEFATION UNITS—H P.EA __ <br /> IAVATORY(WASH BASIN) BOLLERS—H.P.EA. .^ <br /> SHOWEF � GAS FIRED AC.UNIIS— TONNAGE EA_ I <br /> KITGHEN SINK&DISP. FORCED AIR SYSTEMS—8 T.U. �d EA. i <br /> DISHWASHER WAI L HEATERS—B.i.0 b1 ' <br /> IAUNDRY TRAV UNIT HEATERS—B.T.U. M <br /> C�O�MES WASHEP EVAPORATIVE COOlERS � <br /> WATER HEATER CLOTHES DRYERS , <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTFM ��N,F HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT — GF.M. i <br /> VACUUM BREAKERS STOVE <br /> ROOF DRAINS—RAINLEADERS METAL FlREPLACE&CHIMNEY � <br /> SINK(SERVICE—BAR,ETC.) <br /> � <br /> � SUBTOiAI SUB TOTAI f-� � <br /> PENMIT S PERMIT f � <br /> TOTIIL FEE 3 TOTAL FEE i <br /> SIDE VARD SETBACK STREET SETHACK AEAR Vr\RD SET9ACK PLAN CHECK NUMBER FLAN CHECK F[E <br /> � 80/7425 FEE 18.00 aECEiPr No. <br /> USE ZONE LOT AREA VACANT SITE 478 4 <br /> R-2 ❑YES �3�10 FEES VALU�TION fEE � <br /> TVPE OF CONST. OCCUPANCV GROUP NO.OF DWELLING UNITS <br /> V-N R-j 1 eui�oiNc s 36 00 <br /> SIZE OF BLDG. NO.OF STORIES MAX.OCC.LGAD <br /> 16'x16' �C� 1 PLUMBING � <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS MECHANICAL <br /> 3 none REOUIR <br /> ❑YES O <br /> AVPROVAL8 !Y DATE OTMER <br /> 1. ENVIRONMENTALCHECKLIST pENALN U.BC. I <br /> SEC.30J le� <br /> 2. BUILDING PLANS <br /> TOi�L 36 00 <br /> 3. FIRE HVDRANT <br /> 4. FIRE 7POTECTION SYSTEM �ERMIT V10.1DATION <br /> WHEN PROPERLV VALIDATED!IN THIS SPACE)THIS IS YOUR PERMIT <br /> 5. GRADING O `• ' I <br /> 6. DRAINAGE � f�0 3 6.Q 8 -T �,' <br /> ]. ENVIRONMENTALIMVACT 5fA�EMENT � <br /> N <br /> 8 HEALTHDISTRICT YOUR RECEIPT o <br /> APPUCATION ACC.BV PLANS CNECKEO BV APPR.FOR I'aSUANCE BV � <br /> THAI�tK YOU <br /> v.c. <br /> ADDRESS FILE � 4 � �O <br />