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' �',° E���,�"°�.° CONSTRUCTION <br />��„ �>F _ _. <br />everett PERMIT <br />C1Tv HALL?598]45 <br />eve�e.r,wn �aao, COMBINATION • BUILDING • MECHANICAL • PLUMBING <br />o�1Nea nini� nuur�tss zir� v��oNe <br />Jack R. Kosky 5312 East Drive 355-5585 <br />ARCHRECT OR DESIGNER MAI� ADDRE55 l'nnnio- — ��.-o..�a � <br />Same <br />n <br />h101 <br />(�COMBINATION <br />� 6UILDING � PLUM�ING �{MECIi.\NICAI. <br />L <br />❑NEW ❑ADDITION ❑ALTERATION uREPAIR <br />5 %SO.00 � ❑DEMOLISF/ ❑FENCE ❑$IGN ❑SWIMMI� ; POOL <br />DESCRIOL WGRK <br />composition re-roof <br />PROPOSE� USE <br />single family residence <br />IEGAL OESCRIPTION OF PROPE(iTV ISI10W IiE�OW OR ATT <br />FOVR COPI[51 <br />�or 18 �LOCK_OF Highland. Acres <br />JOB ADDRE55 <br />5312 East Drive <br />PLUMBING <br />E <br />MECHANICAL <br />TVP[ OF ENEFGY <br />everett <br />❑GAS ❑ELEC. <br />NO. T�'PE OF E�UIPMENT FEE <br />AIR COND. UNITS-H.P. EA. g � <br />REFRIGERATION UNIT i -H.P. EA. �— <br />i <br />f301L[RS II.P. [4 � <br />FORCE� AIF SYSTEMS-D.T.V. M[A. �— <br />—_ _ _ I ' <br />SPACE & WALL NEATERS - B.T.U. <br />UNIT 11FAiERS-A.T.U. � <br />__ EVAPORATIVE CUOLEfiS _ � <br />CLOTH[;UIiVERS � <br />VLNTIL/�TION FAN �-- <br />RANG[NOpp � <br />Alq HANO:_ING UNIT C.F.M. <br />— _- ____—__—_ ' <br />WATEF HEAT[R <br />- 1 <br />FAC. (iUILT FIRFPLAC[ R CHIMNEY � <br />GAS. SVSTEM: NO OP OVTLE' : T— <br />__ __ __"—" _ __ - ._ _ . �— <br />._."_ —____ ___— —__.—. _. iVU TUTAI 5 � <br />P[fiMIT S 1-- <br />-�—�--�--� ----totni.rEe 5 i <br />Tlllti P[RMIT �ECOMES NULL ANO VOID IF WOfiK OP CONSTqUC <br />110N AUT110RIZED IS NOT COMMENC[D WITHIN 120 DAYS, OF IF <br />CUNSTRUCTION OH WORK IS SUSPGNOE� O(? A�ANOONED FOR A <br />P[RIOU OF 120 DAVS AT ANV TIM@ AFT@(i WOfiK IS COMMENCED. <br />1 II[RCOY CEf1T11=V THAT I IIAVfl R[AD 11NIJ BXAMINED THIS AP� <br />PIICl�TION AND KNOW THl SnME TO liC TRU[ AND COf1R@CT. ALL <br />PHOVISIONS Of LA1Y: AND OfipINANC@S GOVEfiNING tH15 TVPC <br />UI' WONK WILL O[ COMPLILfJ WI111 WHCTHCF SPGCIPIED HEREIN <br />OH NOT, 7H@ GRAN1lNG Of A PUIMR DO[5 NOl PIiESUM[ TO <br />GNC AUIHUHITV TO VIOLATE Ofi C/�NCEI. THE PROVISIONS Uf- <br />ANv OTHfiR STATC ON LOCAL �l�W qEGULATING CONSTHUCTION <br />OR THE P[fiFOl1MANCE OF CONSTfiUCT10N. <br />_L TOTAL FEE � —� X ( , /!�( ��1�_� <br />��-!t_/ <br />7ERSERVICESIZE ULDG.SUPPLVSI7E su; , u�eorGONiqncTo <br />IE VARDSETOACK STR[ETSETOI�CK REl�RyA�1D5@1'OACK PLANCHBCK NUMIl[H <br />SPECIl�L CONDITIONS: <br />3/29/79 <br />.AGENT pATE <br />PIAN CHECK PEC <br />PEE I�ECEIPT NO. <br />❑vES ❑No FEES VALUATION <br />NO.OF OWELLING <br />UNITS <br />MAX, p(;0. LOAO OUILDING 5%SO.00 <br />PWMOING <br />{�IHLSPIi1NKLERS <br />(i[OUIR@D <br />❑Y@S ❑NO MFCHANICAL <br />OTIiEH <br />PENAITY SEC. �OJ lal <br />�,. <br />TOTAL <br />PERMIT VALIDATION <br />WIItNI'NOP[Rl V VfJ IpAiCOIIN <br />� <br />FEE <br />C �1 <br />81 00 <br />� � � <br />t1115 b'AClil 111ti IS YObN P[RMiT <br />� . . ' . <br />YOUR tdECEt�!'T» � <br />iHA�JK Y�U � <br />• r, . <br />_ ,, � <br />,� �9�19. ' ,,� <br />,, . <br />