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l . <br /> r'7eL1C7vGF � �NSTRUCTION � � . <br /> everett PERMIT pERMIT NO. 06674 <br /> C,JTV NG�L 259-b7d5 <br /> rvt�en wF �ezo, ❑ COMbINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> cr:�;o, raaanootitss : n n�• . .. .. <br /> THE INSURANCE CENTER 2321 BROADWAY <br /> . ':r��i(UO��LIESi�'1� MAILADORE55 G�iY 21P PNONE <br /> <�,i��'.�+4L CON�RAROA MAIL ADURE55 CITV 21P PNONE LIGENSE I <br /> SIMCO SIGN CO. <br /> i��;.��ra�i�«[qNiPACTOii MAILADDPE55 GITY ZIP PHONE L�CENSE� <br /> �lLvpit�GCONTRACTOR N".I:ADDPESS QTY IiP PHONE UGENSE� <br /> (I>b50F WORN <br /> ❑NEW ❑ADDITION ❑ALT6AATION ❑PEPAIR ❑DEMOLITION ❑FENCE C�SIGN ❑GARAGE <br /> �J.�,i'r.LON OP WORK <br /> . 600.00 <br /> c��,�.�aoe woarc <br /> nonrm renrr uron. <br /> i .��i JSCO W[0(BUiIDING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP� <br /> .. !..i oixaivnorv oF vnoaearr is��ow oE�ovr on Ar;nc��rcuri cowesi PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> � e�o.K_oF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIR[D <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO� <br /> VISIONS OF ANY OTHER STATE OF LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> ,. .� .--;�r!55 j� 5.S`�AIURLp� rORO�iFU1HJnqEDA6P�r on1L <br /> 2921 PROADWAY X �.<-r�—�/ 9 11 79 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> CJATEP CLOSFT ITOILEi� AIR CONU UNITS—H P.LA. <br /> BATHTUU R[FFIGERATION UNITS—H P EA <br /> IAVATORY(WASN I3ASIN) OOILER$—H P.EA. <br /> SHOWER GASPIREUAC UNITS—TONNAGEEA <br /> KITCH[N SINN 6 OISP. FORCkD Alq SVSTEMS—B T.U. M EA. <br /> DISHWASHER WAII HEAT[RS—B T U. M <br /> LAUNDRY TRAV UNIT HEATERS—B 7L. M <br /> CLOTHES WASNER fVAI'OHATNE COOLERS <br /> WATER HEATER CIOTHESI]RYERS <br /> UNINAI �'ENTItATION FAIJ <br /> DRINKING FOUN7>IN AANGE HOOD <br /> FtOOR DRAIN AIP HP.NDLING UNIT— C.F.M. <br /> VACUUM BREAK[PS STOVE <br /> ROOF Di7AIN5—RAINLEADE(iS MEiAL FlREPLACE 8 CHIMNEV <br /> SMK(SEPVIC[—�AR.ETC� <br /> SUB707AL SUBTOTAL S <br /> PEPMIT f PERMIT S _ <br /> TOTAL FEE S TOTAL FEE S <br /> '::rt�F YARO SETBAfK S7RELT S[T�ACK REAR YARD 58TBACK FLAN CNECK NUMBER PLAN CHECK fEE <br /> F[E �aECEIPT NO <br /> VbLZON[ LOTAREA VAi;ANTSIiE <br /> ❑VES ❑NO FEES VALUATION FEE <br /> 7�+�'fl OP CONST. OCCUPANCV GROUP NO.OF DWELLING UNI75 <br /> BUILDING $ 600.�0 �fl_ <br /> ;:iZ[OF BL�G. N0.OF STORIES MA%.OCC.LOAD <br /> PWMBING <br /> FIRE ZOIJE BASEMENT FIRE SPRINKLERS MECHANICAL <br /> RWUIRED <br /> IlVES f1N0 � <br /> ' APPROVAIS BY DATE OTHER <br /> L CtJVIRONMENiALCHECKLI:.. PENAITV UBC <br /> SEC.303(al <br /> .^ (3UILDINGPLANS <br /> TOTAL 5 00 <br /> 3 PIHE HYDRANT <br /> : I-IRC PHOTECTION SYSTEM PERMIT VR�IDATION <br /> 15'HEN PROPLRLY VALIDAi[D�iN THIS SPAC[11HIS IS 1'OUR PERIAIT <br /> � `��"���� � � 3� soa5.oa �� � <br /> f DRAINAGE <br /> 1. EHVIRONMEN?AL IMPACT SiATEMENi ' �' <br /> � <br /> F,. HEALTH DISiRICT ��O U P. RCG E I P� <br /> APhUCATION ACC.8V PU+.NS CMECKED BY APPF.FOR ISSUANCE OY <br /> THANK YO U <br /> ADDRE55 FILE � 1 � .1 Q <br />