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1 �� <br />rhe Erergreen (� O A' eT ��%~�' O� - <br />cirr oF ./ 1� V! V <br />e�erett PER��� PERM�T NO. 1.14�5 <br />cirr Hn�� zse o�as <br />eveaerr.v;n sszo� ❑ COMBINATION ❑ BUILDING �MECHANICAL ❑ PLUMBING <br />O:INLR lA�ILADORE55 ::IiT ZIP �'11011L <br />�ayie Travis (Headliner�) 1913 Madison Evezett• 98204 <br />nkG10EGTORDESIGNER IdAI�A�ORES$ CRY Zf.' PIIONE <br />BE!lePrtlGC'�TR/CTGH �AARAppPE55 CrtY ZiP �HONE LICENSE� <br />HF.GMnNU�LCOIJ1qPGi0P MAILAO�RESS GTY ZIP PNONE LiCEfJSL� <br />Natural Gas �quipment Co. Inr. 1611 East Grand 962J1 258-%�3�Y 2441 <br />PWMBMGCONTRAGTOR AIAiLADORE55 QTV ZiP PHONE LiC[I15[r <br />CW55OF WOPK <br />�NEW ❑ADDViICN ❑ALTERATION ❑REPAIR ❑DEMOUTION ❑FENCE ❑SIGN ❑GARAGE <br />S <br />paOPOSED USE OF BUIIDING <br />LOT �LOGK__Of <br />O�ADD�E55 <br />1913 Madison <br />PLUMBING <br />NO. TYPE <br />VJATER CLOSET (TC <br />KITCHEN SINK & U�SP. <br />DISHWASHER <br />IAUNDRYTRAY <br />CLOTHCS WPSHER <br />NATEF HEnTER <br />UFINAL <br />ORINKING FOUNTAU� <br />FLOOR DRAIN <br />VACUUM �REAKERS <br />FOOF ORAINS — RAINLEAC <br />SINK �SF.flVICE — BAR ETf, <br />SUB <br />SIDE 1'ARD SETBACK STflEET <br />USE ZONE LOT ARI <br />TYPE OF CONST. OCCUPo <br />SIZE OP BLDG. NO. OF <br />FIRE ZC�NE O�SEA�I <br />OR ITEM <br />1. ENVIRONllENTAL CHECK LIST <br />2. BUILDING PLANS <br />3. FIRE HY�RANi <br />4. FIRE PROTECTION SYSTEM <br />5. GRAOING <br />6. DPAINAGE <br />7. ENVIRONMENTALIMPACTSTATEMENT <br />8. HEALTH DISTR'CT <br />APPLICATION ACC. BV PLANS CHECKED BY <br />REAR YARD SETBACK <br />VACANT SITE <br />❑1'ES ❑NO <br />NO. OF DWELLING <br />MAX. <br />APPR. FOR ISSUANCE BY <br />I HEREBY CERTIFY THAT I HAVE READ A��u EXP.M�VED TH!S AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CGRRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED INITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GRANTING UF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO� <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCI ION. <br />X Nn.ua�oFc�qaoa �r�yenizeq��Hr onre <br />f /�i�r� 2/9/83 <br />L(,� tul/w j✓ <br />MECHANICAL <br />TYPE OF EOUIPMENT <br />AIR CONU. UNITS -- H.P. EA. <br />REFRIGERATION UNITS — H.P. EA <br />�OILER$ — H.F. EA. <br />GAS FIRED AC. UNITS — TONNAGE EA. <br />PORCED Alq SVSTEMS — B.T.U. M <br />WALL HEATEHS — 6.T.U. M <br />UNIT H�ATERS — B T.U. M <br />EVAPORATIVE COOLEflS <br />CLOTHES DflVERS <br />VENTILATION FAN <br />FANGEHOOD <br />AIR HANDLING UNIT— C <br />STOVE <br />METAL FIREPLAGL 8 CHIMNEY <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY <br />TOTAL <br />PLAN <br />FEE <br />VALUATION <br />$ <br />LLB.C. <br />SEC. 303 (a1 <br />RECEIPT NO. <br />14 I 50 <br />14 I 50 <br />WHEN PROPERLY VALIDATED �IN THIS SPACE) THIS IS YOUR PERMIT <br />3287 ,ao t a.5o --�► <br />. � . � ` ' : `, y G7' <br />�D�ii �ECE��r�—i <br />THANK YQU <br />4DDR[SS FILE <br />I O F� 8 S <br />� <br />'J <br />1 <br />� <br />� ' <br />