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_ i <br /> 'h```�R�`�n ; �ONSTRUCTIO� ' 'i <br /> ever�tt PERM � 1 PERMITNO. 16113 i <br /> GTV MALL 259�87C5 <br /> ever+en.wa9azoi � COMBINATIOIF��l�9U(UDiNG C141NIICMA�i1CAL ❑ PLUMBING <br /> I <br /> OWNEA MR1L AODRE55 CITY ZIP PNONE I <br /> Skippezs Inc., 14450 N.&. J.9th Place R200 Bellewe 98007 454-3456 i <br /> AR�nrtEGT OR DESIGNER MLIL RpD9E55 CITY Z�o PHONE i <br /> GENERAL CONTF�GTOP MMt ADDRE55 GITY 2i� PXO�IE LICENSE� I <br /> Ne�taurant Builder� Inc. 1607 132nd Aven'�e N.C. Bellewe 9B005 B81-1985 <br /> MEG�'�NIGAI GGNTRRGTOR M�I�ADORE55 CITY ZIP PHONE LICENSE� ' <br /> PLUMBING CANTR�GTOH MAIL AD�PE55 pTY IIG PMONE LIGENSE• <br /> � � <br /> CLA55 OF WORN <br /> ❑NEW O ADDITION ❑ hLTERATIOK ❑REPAIF C�(SEMOLITION ❑ FENGE O SIGN O WOOD STOVHFIREPLACE INSERT <br /> VALUATION OF WOAN <br /> i <br /> DESCRIBE WORK <br /> Demolish exietinq sarvice station _ <br /> z <br /> PROPoSEO USE OF BUILDING � <br /> I IIEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS � <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND � <br /> IEGAL OESCRIFTION OF PROPERTV ISMOW BELOW OR RTT�GM FOUR CAFIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINAIJCES m <br /> 1� thzu �� 384 Everett Di�. 1C GOVEaNING THIS TYPE OF WORK WILL BE COMPLIED WITH " <br /> T_ cK_oF WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE =i � <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STPTE OR ,.., � <br /> LOCAL LAW REGULATINCa CONSTRUCTION OR THE �' m <br /> PERFORMANCE OF CONSTRUCTION. � o <br /> JOB RUDRE55 SIGNnTyRE�OF�O�RAGT OA 4�1��UA�lED nG[NT 0>1E m O <br /> 1971 Broadwa -1931 Broadwa X� i < - 1 � �," � a�• '' ,� � <br /> O 3 <br /> VLUMBING MECFfANICAL m <br /> I = —zi <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE � <br /> WATERCLOSET�TOILEn AIR COND.UNITS— H.P.EA C Z <br /> BATMTUB flEFRIGERATION UNITS— H.P. EA. � _ <br /> LAVATOFY(WASN BASIN) BOILERS— H.P. EA_ � � <br /> � N <br /> SHOWEP GAS FIRED A.C.L'NITS —TONNAGE EA. < � <br /> KITCMEN SINK d DISP. FORCED 41R SVSTEMS — B.T.U. M EA. <br /> — WALL HEAiEFS— B.T.U. �7 O 3 <br /> DISMWASHER � � m <br /> LAUNDRY TRAY UNIT MEATERS— B.T.U. M m � <br /> CIATHES WASHER EVAPORATIVE COOLERS V� <br /> O <br /> WATER MEATER CLOIMES DRVERS O m <br /> URINAL VENTILATION FAN 3 � <br /> DRINKING FOUNTAIN HANGE HOOD Z n <br /> FLOOR DRAIN AIF HANDLIYG UNIT- C.F.M. -{ r <br /> • m <br /> VACUUM BREAI(ERS STOVE-WOOD . � <br /> ROOF DRAiNS - RAiNLEADERS METPL FIREPLACE 8 CHIMNEV <br /> --i <br /> SINK(SERVICE - BAR, ETQ) FIREPIACE INSERT 9 <br /> HEAT PUMP = <br /> � <br /> _ _ <br /> N <br /> SUB TOTAL t SUB TO7AL f _ O <br /> PERMIT S 7ERMIT f <br /> n <br /> TOTAL FEE f TOTAL FEE _ �T1 <br /> SIDE VARD SETBACK STREET SETBACK PEAq YARD SET9ACK PLAN CHECK NUMBER PLAN CHEf.K PEE <br /> FEE RECEIPT NO. — i <br /> USE ZONE LOT AREA �ACANT SITE FEES VALUATION FEE <br /> :_YES . NO — � <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS I <br /> BUILDING = � <br /> SIZE OF BLDG, NO.OF STOflIES MA%.OCC. LOAD <br /> PLUMBIN(i <br /> PIRE ZONE BASEMENT FIPE SPRINKLERS MECHANICAL <br /> FEOUIFED <br /> VES NO � <br /> APPROV�lS BY DATE O7NER I <br /> 1.ENVIRONMENTAL CHECK U5t PENALTY U.B C. I <br /> SEC.303 Iel <br /> 2.OUILDINGPLANS TpTp� � OOI OO I <br /> 3.FIRE MYDRANT I <br /> <.FIRE PRG?ECTION SYSTEM PERMIT YALIDATION <br /> 5.GR�DING WHEN PROPEHLY VAUDATED(IN THIS SPACE)THIS IS YOUR PERMIT (r� I <br /> �"� <br /> 6.DRAINAGE �{ <br /> 7.ENVIRONMENTALIMPAGTSTATEMENT (,� <br /> B.HEALTH DISTRICT � , <br /> APPLICATION ACC. BY PLANS CMEGKED BY APPR. FOR ISSUANCE?Y ' <br /> � <br /> I I <br /> APPLICANI'S COP'( <br /> � <br />