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`,'"`�"``".,' CONSTRUCTION '' . <br /> ., r � <br /> �V�r��� PERMIT PERMIT N0, l.Jb � <br /> arv ��a��zs9�n;;s '.l 3 <br /> `ve�erT. �,vn ee�a, ❑ COMBINATION ❑ BUILDING L� MECHANICAL ❑ PLUMBING <br /> `.., .'�.; r.�,�a nuo:;�ss cnv zi+ ����cue �. <br /> __jjinhard F A1Vhrt� R51R Frir7a� Avp qR9f1l 9S9 flp�A <br /> ��� . �if i i LLSIGI E❑ MAIL ADDf 5 <br /> UiY ZIP PHOIIE <br /> al�:t n.�L C0�11 R4Gi0R AIAiL ApCRE55 <br /> CItY ZIP PI10.'i[ p,r��. .� <br /> _.Self <br /> !�iC:�u.iJ(ALCOtllR CTOR MqIIADDRE55 <br /> CIiY ZIP PHONE LICCt:,:.- <br /> �'W r,,L�,r:p CONiP5�iOR MAIL AODRE55 CIiV <br /> ��P PNONE �iCFr:::� . <br /> Cf�55 OF 140RK <br /> ❑NEW ❑ADDITION ❑qLTERATION ❑REPAIR �DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> l'AWAiIUN OF WpR�( <br /> � � <br /> DESC810E 1YORK <br /> RemovP PXlC4' �p❑ � <br /> PROPOSE�USE OF BUiLDIl�G <br /> �rca�oesc��rnenorr„o;e�rr�,icv�or.ia.,van,�rTtienvouNceviesi PLICATONCAND KNOW THE SAME TO BE�TRUE'AND COR ECT. <br /> ,�,�_�31��_r�a� � ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNWG THIS <br /> TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFI[D <br /> t 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 OR LOCAL LAIN REGULATING <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> J::tADI,G!ti5 SIG/': OFCO'liR4C10 F11t110R12EDAGEN G11L <br /> � ' XV�C . L /I �. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> l'fATGR CLCSET IiOILEiI AIR COND.UNITS—HP.EA. — <br /> DATHTUB flEFRIGEPAiION UNITS—H.P.EA <br /> IAVATORY�WASM BASIN) AORERS— H.P.EA. — <br /> SHOWEq GAS FlRED A C.UNITS—70NNAGE EA. <br /> KITCHEN SINK 8 DISR FpqCED AIR SYSTEh1S—B.i.U. M EA. <br /> OISNWASHER l'JALf.HEAT[RS—�T.U. �A <br /> LAUNDRY TRAV UNIT HEATERS—B.T.U. M <br /> _ CLOiHES WASHER GVAFpRq7NE COOLERS <br /> WATER HEATER CIOTHES DRYERS <br /> URINAL <br /> VENTILATION FAN <br /> OR W KING FOUNTAIN RANGE HOOU <br /> FLOOR DRAIN AIR HANDLING UNIT— GF.h1. <br /> VACUUM BREAKEHS STOVE <br /> ROOF DRAINS—RAINLEADERS MEiAL FIREPLACE&CHIMNEV <br /> SINK(SERVICE—�AR.E7C.) . <br /> SUB TOTAL SUBTOTAL S <br /> PERMIT S PEHMIT 5 <br /> TOTALFEE S TOTAL FEE S <br /> SIDE YARD SETBACK SiRE[T SETt3ACK qEAR YARD SETBACK PIAN CHECK NUMBEfl PLAN CHECK FEE <br /> FEE FECEIPi NO <br /> USE ZONE LOi AREA VqCANT SITE <br /> ❑YES ❑NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP N0.OF DWGLLING UNITS <br /> SiZ[OF�LDG. NO.OF STORIES MW(.OCC.LOAD BUILDING b O <br /> � 0 <br /> PLUMBING <br /> RRE ZONE BASEMENT FIRE SPRINKLERS <br /> REOUIRED MECHANICAL <br /> ❑YES ❑NO <br /> APPHOVALS BY DATE OTHER <br /> t ENVIRONMENTAL CHECK LIST <br /> PENALTY U.B.C. <br /> �. �UILDING PLANS SEG.303(a) <br /> 3 RRE HYDRANT TOTAL <br /> ;. FIRE PROTECTION SYSTEM PEqMIT YALIDATION O O <br /> 5 GRADING �VHEN PROPERLY VALIDA7ED pN THIS SPACE)THIS IS YOUR PERAIIT <br /> ti DRAINAGE O��o� �O O ua Q j� "'�'• '`i> <br /> 7 F.NVIRONMENTALIMPACiSTATEMENT . �—� <br /> N HF.�LTH DISiRICT � <br /> p n 1ry�/� f,:) <br /> ,�1-�PUC.IiON ACC.BY PLANS CHECKED BV APPR.FOR ISSUANCE�Y ���,�fiR i`�C E!L"� (� <br /> � .. ,. ., � � �.,' �� <br /> i U +'•��� 1 tl <br />