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t!j(_rCr��rCCn • �Q TRl1CTIO�N � � <br /> r i i c" ' <br /> everett ERMIT pERMIT NO. �6�' ( .� <br /> Giv HALL ?59-87»5 <br /> t:��r,err,ed;, �e�oi ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> ,...�.:.�� ���,,.n:;uuiss cn, zia vHor�e <br /> �,Ponard D. F.]�{rom 4924 Q1ai�Pr r.anP FVPrai-' 9R704 759-7444 <br /> .,.�c���reer on ocsiar�tn r.�na aooaess cirv zi� rHon�c <br /> ,A1:ENA�CONTRACiOB 1.!qILld�DRE55 CITY J�P PNO4E UCENSF.� <br /> _S�� <br /> C!�:�V�NICALfANTRACTOP MAILADORESS C�iY ZIP PMONE �ICENSE • <br /> '.^.i:[1'!lGGCt�iRAGiON AIqIIADDRE55 GTY IIP PMONE �IGENSL• <br /> �:i%•55OF WORN <br /> ❑NEW ❑AODITION ❑ALTERATION f[�REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> G.LUATION OF VlOPN <br /> � 120�. 0� <br /> Ci.SCPR3L\VORK — <br /> New Roof <br /> i'i:0i'USF.D USE OF B W IDiNG — <br /> I HERE9Y CERIIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> i�a.,�o:;cnivnor+oFaaoPcrur�s��o�vueiov�canrracNFouncoaies PLICATION AND KNOW THE SAA4E TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> . . =� niocK_oF 13£G �dqP TYPE OF 1NORK WILL BE COMPLIED WITH WHETHEP SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO Glb'E AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATIIJU <br /> CONSTRUCTION OR THE PERFORVIANCE OF CONSTR'JCTION. <br /> JOB.Ol;ii55 �161111UPEOFC0Y1 OfiqU➢V RI'EDAGENT l�wlf <br /> x•�' �-,.-..,. j ' .-�-� 9- <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTUHE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CIASET(i01LET1 fJR COND.UNITS-H.P.EA. <br /> BAIHTUB FIEFqIGEF'ATION UNITS-H.P. EA <br /> I AVATORY�WASH BASIN) BOILERS�-H.P.GA. <br /> „HOWER GAS FIREU A.C.UNITS-TONNAGt EA. <br /> KITCHEN SINK R DISR FORC[D aIR SYSTEldS-B.T.U. M EA. <br /> DISHWASHER IVALLHEGTERS-B.T.U. M <br /> LAUNDRI'TRAV UNIT HHqTERS-B.T.U. M <br /> CLO�HES WASHER EVAFOPA7IVE COOLERS <br /> \YATER H[ATEH CLOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> UFINKRJG FOUNTAIN FANG[HCOD <br /> FLvuF GRAIN AIR HANDLWG UN11 - C.F.M. <br /> VACUUAIBREAKERS STOVE <br /> ROOF DRnINS-RAINLEADERS METAL fIHEPL�CE d CHIM1INEY <br /> SINK(SERVICE-BAR,ETC.) <br /> SUB TOTAL SU�TOTAL S <br /> PERMIT S PERMIT S <br /> TOTAL FEE S TOTAL FEE S <br /> E�D[VARD SETBACK SiREET SET�ACK REAR YARD SET�ACK PLAN CHECK NUM�ER PLAN CHECK PE[ <br /> FGE fiECEIPT NO <br /> WEZONE LOTAREA VACANTSITE <br /> liVES ❑NO FEES VALUATION FEE <br /> T1'FG OF CONST. OCCUPANCY GROUP N0.OF DWELLING UNITS <br /> SIiF M BLDG. NO.OFSTORIES MNc.00C.LOAD BUIIDING S ZZOO.00 ZZ OO <br /> PLUMBING <br /> FIRE ZONE �ASEMENT FIRE SPRINKLERS -- <br /> RCCUIfiCD t.1CCIlANICAL <br /> ❑YES ❑NO <br /> —� APPAOVAlS BY DATE OTH[R <br /> 1 ENVIRONMENTAL CHECK LIST <br /> PENALTv U.B C. <br /> :' [9UIL�ING PLANS SEC.3031a) <br /> 3. FIREHYDRANT ' T�TA� ' �.Z OO <br /> a FIRE PRO7ECTION SYSTEM PERMIT VALIDATION � <br /> WHLN PROPEPLV VALIDATED IIN THIS SPACE)THIS IS VOUR PEq1dlT <br /> S GHADING �-.-{ <br /> � or�nwnce 3 9 6 9 j� � Z.�� � f1= <br /> ! LNVIRONMENTALI�dPACTSTATEMENT � <br /> � N[ALTH DISTRICT �p' •c t 7 CU <br /> nl'�LICATION ACC.BY PLANS CMECKED BY APPfl.FOR ISSUANCE BY � �YC�,V'R R GC E 1 P 1 � <br /> THA1�K YOU <br /> ADDRf'.SS FILI .J � ��T 7�I <br />