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l' 1 �y � <br />A70x <br />�HSt~n <br />yZH <br />�H� <br />� H '� <br />f/1 H <br />�O� <br />OH <br />��g <br />�1] Y (7 <br />t"y� <br />ri y <br />g�' <br />H <br />OCyN <br />��t.7 <br />ZHcn <br />HOfn <br />`�E`""�'�"' C )NSTRUCTION p�7 <br />Cln Ci- - <br />everett PERMIT PERMIT NQ:- �� �`� f <br />259-8745 <br />❑ DEMOLITION ❑ COMBINATION L�BUILDING ❑ MECHANICAL ❑ PLUMBING O SIGt�! <br />pNi�f B A�PR PpDd64 CI1T ZIP p�DNE <br />Ginger Norgaard 5411 Colby Ave. iVerett %203 351-2206 <br />♦opaiELTORD6�GNCB MAILa�DA65 CITv ZIP PHDNE <br />GCN[fULCCNTMCTOH M1ILADDNE55 CITY ZIV A�ON[ LICC1..! • <br />owner <br />b•!C���NiCAICOviR�LTOF MRILA�DRESS CITY ZIP MON[ ULCr:G! <br />PWUB�NGCANTR�CTOR MRIL�CDnE55 GiY ZiP PMONE I�CLtiSS• <br />❑ NEW ❑ ADDITION <br />5 15.000. <br />[� ALTERATION ❑ NEPAIN ❑ DEMOLITIOW ❑ BUILDING RELOCATION <br />Alter si.n le famil residence to du lex <br />HGt $OURC[ <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTIIEH <br />rmoroscauscoroimowc I HE9EB1' CERTIFY THAT I HAVE READ AN') EXAMINED THIS <br />W lBx APPLiCATION AND KNOW THE SAME TO BE TRUE AND <br />i[cniowcnmrior+orw+oveatrrsNcweeiowonnnncNrouncoPi�si CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />8 1 Laurel Hei hts GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />iot _ e�ocn _ nr WHETHER SPECIFlED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHOFITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANV OTF'ER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PEgFORMANCE OF CONSTRUCTIpN. <br />u�ue d �r�nuinnfi%�K1.ViHO11i1C�PLENT OI�OWNEII % ��T�J <br />PLUMBING <br />NO. TYPE OF FIX � UHE OP ITEM <br />� WATEq CLOSET (TOILETI <br />� OATHTUB <br />d LAVATORY(WASH�ASIN� <br />(1 KITCMEN SINK d DISP. <br />d DISHWASHER <br />CLOTIIESWPSHEP _ <br />URINAL <br />pRINKING FOUNTAIN <br />FLOOR DRAIN <br />ROOP DRAINS — HAINLEA�ERS <br />SINN �SERVICE — �AR, El C � <br />R-3 <br />tYFE OF GONS <br />V-N <br />Si2E Of OLOC. <br />910 <br />RI'PLIf.RT�ON M1CG [�V <br />S . li. <br />SVBTOTFL <br />PERMIi <br />TOTAL FEE <br />fiEP�i'.Eil1A!'.K <br />Z� <br />LOT nBER <br />OLCUPRNCYGHOUP <br />R-3 <br />NO OF STOR�ES <br />1 <br />7 ❑ YES � NO <br />RANS GM[CNED OY <br />J.W. <br />FEE NO. � / TYPE OFLEOUIPMENT <br />S OO AQ—AMNpLGUN1T$--HP. _ <br />S OO REFRIGERATIONUNITS—NP EA <br />rj 00 OOILERS—BT.UMP. <br />GASFIIiEOAC UNITS—BTU <br />5 POiiCEO Alfi 5V$TEIAS — � i U. M EA <br />5 YlALL MEATERS — B TL Id <br />UNIT NEATERS — � 1.0 M <br />r� EVAPORAiIVE COOLEFS <br />CLOTHES�RYER$ <br />VENTILATION FAN <br />qANGEHOOD <br />WAIERHE�TER � �-� <br />WOODSTOVE _ <br />METAL FlPEPLACE E CHIMk � <br />FIREPLACE MSEiiT <br />HEAiPUMP <br />GAS PIPING <br />E%HAVSTFAN p C��u <br />�s <br />so[seinncrc <br />5 <br />VACRM SRE <br />] YES � NO <br />ND 01 OWEIUNG UNIIS <br />Z <br />IAAX OCC LORO <br />N/A <br />nnrn ron usunNceor <br />J.W. <br />PLAN CNECK NI/M <br />88/21347 <br />SUB <br />fEE <br />105.30 <br />FEE <br />14641 <br />FEE <br />�UILDING S SS <br />PLUM8ING <br />MECHANICAL <br />INVESTIGATIONF[[ Se0.30�1(e) <br />STATE OUILDING SURCNARGE <br />STATEENEflGVSURCNARGE <br />OFIIVEWAY PEfiM1T <br />TOTAL 219 <br />PENMIT YALIDATION <br />WNEN PROP[FLY VAlIOAT[� (IN iHlS SPAGE) THIS IS YOUR PE/i1dIT <br />e <br />