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� P'PLiCATION FOR e�� <br /> Clrr oF�gr�^ .:O N 5 T R U C T I O�1 <br /> i �verett PE RM IT <br /> DEPT. OF COMMUNITY DEV�LOPMENT $ERVICES <br /> I CITY HALL 259�8745 <br /> il eveRei7,wnvaio�OMBINATI�JN �UILDING ❑MECHANICA'L �LUMBING PE�tMIT NO. <br /> C N'Nt 0. <br /> nun mOxiss an Zir vnuMt <br /> � 3a�Y L c n� 1_ '3 1� )/c�- .L�� -�-if/4 �a: o� � Z. 2�7� <br /> �qCllliFCi F�[SIGNIX <br /> MeIlAOD0.t5S CILV ZIp CHONE <br /> G[N[N�l CU�+IN�CtOR MAII ADDR65 CIiY ZIP PHON[ LICFNSE I <br /> M[CN�YIUI COM1IP�CiOR h1Ml�OOPlSS CIIY LIP PIIONf IICFNSE M <br /> YIUb�ONLCONiR�CLON bInILAD�Hf55 CIIY ZIP �NOM1E IICENSEM <br /> CINSOf KOR< <br /> ❑NE1Y ❑ADDI710N ❑ALTERATION �EPAIR ❑DEMOIITION ❑FENCE ❑SIGN ❑GARAGE bU1LDING RELOCATION <br /> y�����{iON Of WORK <br /> f � U�2 <br /> OISCMIIII WORt % � � <br /> �'• �I A.,-. — - / / <br /> p. �/' �� r`G- <br /> rxor sto��si or nwiowc � I HERER'f CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> PLICATION AND KNOW THE SAME TO 6�TRUE AND CORRECT ALL <br /> i[wi oucuirrio�o�r�:oviatr�v�owrv nuowou nrrncH ioua coens� PROVISIONS OF LAWS AND ORDINANCE$GOVERNING THI$TYPE <br /> Ot WORK WILL �E COMPLIED WITH WHETHER SPECIf1ED HEREIN <br /> i�r_xiocx__uv OR NOT. THE GRANTING OF A PERMIT OOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> [1R THE PEP.F^R".1ANC[ OF CONSTRUCTION. <br /> SIGNA OF fONTRnCTOR OR AUTHORIZED AGENT DATE2��.�—�y <br /> I <br /> InN nf]IlRF55 �� �� �� L,^ ^ �j ' <br /> !�).—Yi. Z.. <br /> PLUMBING ME` A A� <br /> FEE N� TYPE OF EQUIPMENT FEE <br /> NO. TYPE OF FU1URE --_ <br /> 1h'ALIRCLOSETITOLIFTI _ d WNU UNiU—MY kA <br /> REFRIGERATION UNITS—H P EA <br /> {7MM�UH <br /> lA\'�TORY�WASHIIASIN� Od E101LEHS—HP EA <br /> SHOWfR Qd GASfIREOACUNRS—TONNACEEA <br /> '— IONCFD AIN SYS7EM5—B T U M EA <br /> KITCHEN SINK 6 OISP <br /> WALL MEATEHS—!7 T U M <br /> I DISW ASHf R <br /> UNIT HFATERS-0 T U M <br /> I UUNDHY iNAY <br /> CLOIH[5\YASMFR fVAPORA7IVF COOI.FRS _ <br /> CLGTH[i GritiERi <br /> \YA1[R MFATFR <br /> Vf Ni1U710N FAN <br /> UNINAL <br /> pNIMJNC FOUNiA1N <br /> ftANCEHOOD <br /> AIR HAN�LING UNIT— C.F M <br /> FLOOH�NAIN <br /> \'ACUVM1I IIHEAKLR$ $70VE <br /> ROOf DNAINS—kAINLfADERS M[Ul(BEPUCE 8 CHIMNEY <br /> SINK pFHVICI—NAR,f TC I <br /> SUB 70TAL S <br /> SUB TOTAI <br /> PfRMIT S PERMIT S <br /> ' 3 O� TOTAL FFE s <br /> TOTAIiEE <br /> PUN CHEIX FEE <br /> ^ SIDE YAND 5lTIlACK STREFI�SCTIIACK RUH YARO SETUACK PUN UICCK NUML'ER FEE NKEIPT NO. <br /> USF ZO�JE LOT AREA WUNT SIiE fEES W WATION FEE <br /> �Y6 CNO <br /> , TYPE O� CO'�Si OCCUPANCI'GROUP NO OF DWELLING UNITS Q <br /> ouuoinc s�pp `� D 0� <br /> SIZE OF I1LDG NO OF STORIES 1 iA% OCC LOAD <br /> NWMOING � d <br /> fBCLONC UASEMENT 11F1]HOOM' � Q�RFI�NKLENS MFCIIANICAL <br /> I��YfS C1N0 <br /> APPNOVALS •1 BY DATE OiMER <br /> l <br /> i ENVINONMfNTALCHICKl15T U.BC. <br /> PFN�LTY SEC 303(a� <br /> 7 11UIlOING VLANS 70TA1 <br /> ) FlliF HYDRANT <br /> a FINE PROT[C1�ON SYS7EM PfRMIT VAUD�iION � <br /> WHEN PftOPENLY VALID�TE�UN THIS SPACEI TMIS IS YOUR PERMIT <br /> 5 GNAUINGI%UVAi�ONBQfANINGIGRUN111NG ' <br /> 6 DRAINAG[ <br /> 7 ENVIFONMfN7At IMPACT STATEMENT <br /> 8 HEALihi DIiTRICT <br /> APYIIUiION ACC BY PLANS CHECKfD BY APPR FOR ISSUANCf OY <br /> y.�.,-y <br /> i <br /> �i�. <br />