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r�,c eca,�,.o,�n <br />rirv c>F <br />evere%t <br />arr iaa�� z,� a�ns <br />Ev[r�Err,vdn �ta��i <br />coN�rRuc-ria�v <br />PERMIT <br />COMBINATION = BUILDING • MECHANICAL • PLUMBING <br />everet`. <br />OWNEfi MAIL AUGHE55 LIP PIIUNE <br />'D <br />Sose h Turle 322 hfadison m <br />P y —. � <br />nacrureCr o� oe.sicN=_n n^.nit. noo�[ss ��i�orie i_icervSE No. � <br />-� <br />GEN`_qAl. GON'�NI�CTOF MAIL ADDH[SS PHONE LICENSE NO. z <br />Evergreen hlaterials Supply 20G24 87th S9. 223-01-LE Df0 NR 3?D7 C <br />MECHANICAL CONTRACTOR MAIL A�ClRE55 PHONE LICENS[ NO. � <br />� <br />m <br />PLUMBINGCONTFACTOR MAILA�DRESS PHONE LICENSENU. - � <br />PLPMIT CLA55 OF WORK � <br />❑ COMBINATION <br />❑ [3UILDING ❑ PLUA101NG ❑ MECHANICAL �a,., <br />❑NEW ❑/1ODITION ❑/�LTERATION �yi,.,�[PNR <br />VALUATION OF WORK <br />5 3�BOO.00 ❑DEMOLISH ❑FENCF. ❑SIGN ❑SWIMMIYG POGI. <br />OESCRIBE WOFh <br />reside existing dwelling <br />PFOPO:ED USE MECHANICAL <br />�ingle family --- — — <br />LEGAL GESCRIPTION OF PHOPEHTV ISHOW BELOW ON AtTl�CH TYPE OF ENERGV <br />FOUfiCOPIE51 ❑GAS ❑ELEC. <br />21 BBVBYly Hi115 DiV. S NO. TVPE OF EQUIPMENT FEE <br />LOT pLOCK_OF -- - <br />A�R COND. UNITS-H.R Gl�. 5 I <br />REFRIGEIif�TIONUNIT; I�I.P.EA. <br />--- OOILERS ILF.[l�."� ----""— � <br />FORCED nlq SYSTEtdS-Ii.T.U. MEA. <br />__ _ _-_ I _ <br />JO� AODR[55 PACE 14 \NALL HEATERS - B.T.U. <br />_ �J _ � <br />322 �1adi.son I UNIT HEATeRS �ft.T.V. I <br />GVl�PORATIVE COOLEflS <br />PLUM[iING CLOTHES DRYERS <br />V @NTILATION PAN <br />� RANGEHOO� I <br />NO. TVPE OF FIXTURE OR ITEM FEE nla hlnNouNG VNIT- aF.M. <br />BATH TIIBS 5 � <br />CLOTHES WASHEF � '-----"---'-- ' — — <br />DISH WASHERS � .._ _Wf+TEP_HEATER____ ___ _ <br />FAC.BUILT FIqEPLACE R CHIMN[Y � <br />DRINKING FOUNTAINS i --------- ------- <br />GAS. SVSTEM�. NO OP OUTlETS � <br />Fi_ooaorinivs ' -------- suoToi�� s i <br />KITCHEN SINKS & DISP. i _ _._ <br />BAR SINKS i PERMIT 5 <br />ROOF f]RAINS - RAIN LEADERS i iOrnL FEE 5 � <br />SHOWER fiATH$ —� THIS PERMIT 6ECDMES NULL ANU VOID IF WOFK OR CONSTRUC <br />�ERVICE SINK$ T�ON AUTHOFIZ[D IS NOT COMMENCEO WITHIN 120 DAVS, OR I� <br />SUMPS - SEWAGE PUfdP CONS��RUCT1oN OF WORK IS FUSPENOLD OR AonNDONED FOR n <br />� PERIOD OF 120 �AVS M" AN`� ',IME 11FTEF WORY. IS COMMENC[D. <br />URINALS <br />WATER CLOSETS I I HEREf1V CER?IFV iHAT I HAVE RE�1O AND EXAMWED THIS �1N <br />PLICATION M1FO KNOW THE SAME TO [l[ TfiUE AND COfiHECT. ALL <br />WATER HEATERS - ELECTRIC _ � PRpVI5lON5 Of- LnwS nND oHnINnNCES GOVERNING THIS TYPC <br />WASH BASINS i OF WORK WILI. 6E COMPLIEG WITH WHETHF.R SPECIfIE� HEREIN <br />LAUNDRY TRAVS JFl NOT, THE GRANTING OF A PERMIT OOFS KOT PfiESUME TO <br />� GIVE AUTIiORITv TO VIOLME Ofl CANC6L 111L FfiOVI:JONS OF <br />11NY OTHGR ST/1TE OR LOCAL Ll�W REGUI./1T WG COFST(3UCTION <br />� OR TH[ P[RFORMANCE OF CONSTRUCTION. <br />__ 1 Y— <br />SUB TOTAL � <br />PERMIT 5 <br />TOTAL FEE x ���' �� �`� B�.LO�%8 <br />WATERSERVICESIZE �LDG.SUPPLVSIZE SI n Uq[oPCJNTHnCTORURnUTii.nr,EN�� ��DnTE <br />SIDE Vl1H0 SETEACK STREET SET�ACK REAR VARDSET�AGK PLAPI CHECK NUMft[li PInN CHECK f LE <br />f-EE PGCEIPT NO. <br />USE ZbNE LOT AflEA VACANT SITE <br />❑vEs ❑No FEES VALUATION FEE <br />TVPE OF CONST. OCCUPANCY GROUP NO.OF OWFLLING <br />UNITS I <br />SI2E OF BL�G. NO. OF STORIES MAX. OCC. l.OAU RUIL�INI: 5 3 �BOO.00 ZS � OO <br />_ _ — t_ <br />PLUM�ING � <br />fIREZONE �ASEMENT HRESPRINKLEHS 1 <br />REOUIflED 1 <br />❑VES ❑NO MECHANICAL � <br />_ ; <br />SPEQAL CONDITIONS: OTHLR � <br />---- --- PFNI�LTY SEC.90J�a1 I <br />—_ __ I _ <br />TOTAL ZS IOO <br />� PERMIT VALIDATION � ��-/•�� � -�.i1�1�'�9p'A � <br />----- . WHENPFIOP@Fl�YVALIOMEDII Ilf rnc '�M!'�'�iF3V��7+�+� <br />_ _ - --- ---- �fC)UR�;RE�'�tPT <br />' iHANIC Yl�ti <br />.� <br />c��+�irt.r.rn,i ..�.iriiuur rinn;nnr.K�u�rc� nrrnuvi� i n� _. iir_ni�i i, <br />� � � � <br />eb t " � <br />" ! Aa,c70 � <br />