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,,".`�","`.`�° C�1NS�RlJC'i'ION - <br />�,��,� <br />� evereti P ERM ii <br />arr Hnu zss.s�as PERMIT NO. G�'i �� 6 <br />�veaerr, wn 9azoi ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ pLUMBING <br />.:.�i�u r.�nano��tss cirr nF <br />F��U�E <br />Norma L. Durr 6228 Lombard 98203 353-8822 <br />- ����.��RECT OR ptSiGNFR AIAIL ADDRE55 <br />��t� ZIP ounur <br />(:=•:-���:LCOYTRhCiOR IAAIIPODRE55 CITY 71v PHONE LICENSE� <br />Same <br />'.'=CnFhiGLGONiRqGiOR MAILA�ORE55 CRY ZiP PHONE UCENS[r <br />� I UN[iING LONiRACTOfl MAIL F�ORE55 CIiY ZIP <br />PHONE �ICEN>E ♦ <br />C'.��55 OF WORN � <br />❑NEW �]ADDITION ❑ALTERATION ❑REPAIR Q�EMOLITION ❑FENCE ❑SIGN ❑GARqGE <br />: ���.. t1F➢ON OF \VORN <br />..,SCRI�E WORK <br />Demolish exist <br />r�:.o:oseo use oc ouaoir+c <br />single family <br />i.i.ocL �ESCRiPiION OF FROPERTY �SIIOW B <br />.. �r 17—.':ai.cr.k3 oF Pin <br />�,�� ;, n on[ss <br />6�2�28 Lombard <br />FLUMBING <br />NO. TYPE OF <br />WATEfl CLOSET QOILE' <br />BATHTUB <br />LAVATORV�WASH BASI <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />�ISHWASHER <br />LAUNDRYTflAY <br />CLOTHES WFSHER <br />WATER NEATER <br />URINAL <br />DRINKING FOl1NTAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINIEADEpS <br />SINK fSERVICE — BAR, E7G) <br />SUBTOTAL <br />PENMIT <br />TOTALFEE <br />SIDE YARD SETBACK STRLET S[T�ACK <br />CANST. <br />GROUP <br />t ENVIRONMENTAL CHECK I.IST <br />2 BUILDING PIANS <br />3. FIRE HYDRANT <br />4. FIRE PHOTECTION SVSTEM <br />5. GRADING <br />G. DRAINAGE <br />i. ENVIRONMENTA� IMPACT STATEMENT <br />6. HEALTH DISTRICT <br />nPPLICATION ACC. BY PIANS CHECNED BV <br />rage <br />I HEREBY CERTIFY THAT I HAVE READ AND EXP,MINED THIS AP- <br />cor�esi PLICATION AND ;:NOW THE SAME TO BE TRUE AND CORREC7. <br />_ A ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNIMG THiS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRI; <br />VISIONS OF ANY OTHER ST�TE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PEgFORMNNCE OF CONSTRUCTION. <br />5��NjAi ���E OG rONiFRfiO. OR AUTI IZED A�E11i DATE <br />X1 /�-,rr.... � l .. � � 6/21/79 <br />SET�nCR <br />❑YES UNO <br />APPF.FORISSUANCFdY <br />NO. � TYPE OF EOUIPMENT <br />AIR COND. UNITS — H.P. [A. <br />f±F.FRIGERAT10N UNITS — H.P. EA <br />80'LERS — HP. EA. <br />GAS FlHED l�.0 UNITS — TONNAGE EA <br />FOFCED AIR SYSTFMS — B.T.U. M EA. <br />WALL HEAT[RS — B T.U. M <br />UNIT HEA7ERS — B.T.U. M <br />EVAPORq7WECOOLERS <br />CIOTHES DRYERS <br />VF.NTILATION FAN <br />RANGEHOOD <br />_ AIR HANDLING UNIT — C.F.M <br />rLqN GHECK NUMBER PLAN <br />FEE <br />FEES VALUATION <br />OUILDING g <br />PLUMBING <br />MECHANICAL <br />FECEIPT NO. <br />FEE <br />PENALTy U.B,C. <br />SEC. 303 (a) <br />TOTAL . OO OO <br />PEqMIT VALI�ATION <br />IVNEN PqOPERLY yA:IDATED QN THIS SPACE) THI515 YOUF PEFM❑ <br />850p SOOA.�,Q —a�i , <br />' N <br />�'O'U'R RE�Et!'7� <br />� �'MANK Y�(� <br />; <br />i <br />-J <br />a <br />�' <br />�.. <br />