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�'"r�"`�� •✓ ❑ COMBINATIUN <br />�,��o�,� v�u ae.�ui <br />CITY <br />PHONE LIGENSE 1 <br />�S � 71 fi l �IGENSE I <br />PHONE <br />_.._... i IfFNSE f <br />lAAIL AUDRE55 <br />CITY Z�P <br />'�NG GON'. flACTOR <br />OF WOPK <br />❑NEW ❑ADDIiION ❑ALTERATION ❑REPAIF ❑DEMOLITION ❑FENCE ❑SIGN GP.RAGE <br />TION OF WORK <br />' ����� <br />)ESCRiBE WORK <br />20' x�4' �ara� <br />�novoseo usE oF euaoiN� <br />�araeP — <br />�EGAL DESGRIPTIO�� OF PROPEFTY (SI <br />�or e�.oCK�oF — <br />T 0 t ��� <br />Plat �f F�•. Di <br />JOB/DURE55 <br />vr�� inml�aTf� <br />pLUMBING <br />N0. TYPE OF <br />JJATER CLOSET TOILE" <br />BATHTl18 <br />•IAVATORY�WASH BAS <br />SHOWER <br />v�.�ucN SWK 8 UISP. <br />� <br />� <br />SIDE YARD SETBACK I STREET SET�ACK <br />,`�_N-___ M-1 <br />'�IZE OF BLDG. NO. OF ST <br />20'X24' 1 <br />'IRE ZONE BASEMEIJT <br />3 <br />APPHOVALS <br />1. ENVIRONMENTALCHECKLIST <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />4. f-IRC PROTECTION SYSTEM <br />5. GRADING <br />6. URAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />B. HEALTH DISTP�CT <br />_--- <br />APPLICATION ACC. 8Y PlANS CHECKED BY <br />V.C. <br />I HEFEBY CERTIFY THAT I HAVE READ AND EXAMIN[D THIS �P• <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />TYPE OFVWO K Wll BE COMPLI�EDDWITH WHETOHVEH SPECIF CID <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TNE PRO- <br />VISIONS OF ANY OTHER STATE OR LOCAL IA4N REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTR�UCTION. <br />SIGN��E OF CANTRAC/TO�R OR A/l [}1OP�2ED AGe �/�� <br />X /M'l�f� 1�� ��\j—rCi"— � <br />9EAP. YARD 51 <br />VACA� <br />❑YES LhNO <br />N0. OF DWEL <br />1 <br />qppR. FOF ISSUANCE BY <br />TYPE QF EOUIPmtrv i <br />41F COIJD. UNI(5 — N P. EA. <br />PEFPIGERATION UNITS — H.P. EA <br />BOILER� EA��� <br />GAS FIRED A C. UNITS — TONNAGE EAM <br />FORCED��F SV�TEM6 — B T._— �- -- <br />WALLHEATERS—F�T��� M <br />...�.����nrooc—RTII. M <br />IpT O <br />7386 FEE 24.00 I ���8� <br />: 11 11 � 11 <br />PLUMBING <br />MECHAI�ICAL <br />OTHER <br />U.B.C. <br />?ENALTY SEC.303(a) <br />- 48 00 <br />TOTAL <br />PERMIT VALIDATION <br />WHEIJ PFOPERLY VALIDATED (IN THIS SPACEI tHIS IS YOUR PERMIT <br />..065 soag.o�—� <br />M <br />. � <br />;'C�U'R R[CEIPt � <br />�, , a,�r� K ��o u <br />�%i„7u0 <br />��,00r:Ess r-i�� <br />� <br />