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- , <br /> ���� �,���xfef° � C'�(�~TRUCTION - <br /> GTY OF <br /> e�,erett PERMIT PERMI7 NO. OH524 <br /> CITY �'LL 2S9-B7d5 <br /> EVE�R'wa sezo� ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> � reniiaooness cnv zia arnr�c <br /> ov <br /> F.dwin. Patarenn 1$�?_l{�nV9 gye�e�� 9A�f11 �SR_� l�p <br /> ARGNIiECi OR OESiGNER IAAII F RE5$ CITY ZIP PHONE <br /> GEHERA�CON!RACiOR MAIL PD�RE55 CIiY ZIP PHONE LICENSE/ <br /> Self <br /> AAECNANiCALCONiRAC10A MAILF�DRE55 �ITY ZIP PHONE LICCi:SE♦ <br /> PLUMBINGCANTHACTOR MAIL ADDRE55 CIiY ZIP PHONE UGENSE� <br /> CLASS OF WOHN <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGc <br /> VALUAiION OF WORK <br /> E <br /> pE5CRI0E WOBK <br /> Put fire lace i <br /> PROP�SE�USE OF LUILOInIG <br /> I HEREBY CERTIFY THAT I fiAVE READ AND EXAMINED THIS AP- <br /> iecn�oescaivnoruoFcaoPearr�sHowoe�o��voHnnncNFouacoaies� PLICATION AND KNOW THE SAME TO BF TRUE AND COFRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> ior e�oc�oF TYPE OF WORK WILL BE COMPLIED WITH WHE'i HER SPECIFIED <br /> HEFFLV OR NOT. THE GRANTING OF A PERM17 DUES NOT <br /> PRES!JME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PFO� <br /> VISIO�S OF ANY OTHER STATE OR LOCA�_ LAVJ REGU�JaTING <br /> CONSTRUCTION OR TJd� � FORh1ANCE OF CONSTRUC"ION. <br /> �oono�•aess siennr .� cornv+ncrory�(n� a� un�a+r onre <br /> 1502 Hovt X ���./L <br /> PLUMBING MECHAtJICAL <br /> NO. TY?E OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT F�E <br /> 1YPTE9 CLOSET(iOILEn AIR CONL UIJIiS—HP.EA. <br /> BATHTUB qEFRIGERATION UNITS—HP.EA <br /> LAVATOPY iWASH f3ASIN) BOILERS—FI P EA. <br /> SHOWER (�AS FIRED A C UNITS—(ONNAGE EA. <br /> KITCHEN SINK&OISq FGRCED AIR SYSiEMS—B�.U. !d EA. <br /> DISHWASHEii WALL HEATERS—�S.U. M <br /> LAUNDRV TRAV UNIT HEATEPS—8 T U. M <br /> CLOTHES WASHER EVAPORATIV@ COOLEPS <br /> WATER HEATER CIOiHES DRVERS <br /> URINAL VENTILATION FAN <br /> �RINk.ING F�JUNTAIN flANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— GF.M. <br /> VACUUM OREAKERS SiOVE <br /> ROOF DpAIMS—RAWLEADEPS METAL FIREP�ACE L CHIMN"Y <br /> SINK�SERVICE—BAR ETC.i <br /> Fire lace insert <br /> SUBTOTAL SUBTOTAL S <br /> PERMIT f PERMIT S <br /> TOTAL FEE Y TOTAL FEE S 7 5 0 <br /> SIDE VARD SETBACK STREET S[TBACK FEAF YAqD SETBACK PLAN CHECY NUM�BR PLAN CHECK FEE <br /> F[E RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> LIYES L7N0 FEES VAWATION FEE <br /> TYPE OF CANST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> �UILDING E <br /> SIZE OF BLDG. NO.OF STORIES MAX.OCC.LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS — <br /> REOUIRE`J MECHANICAL <br /> f]YES []NO <br /> APPROVALS BY DATE OTHER � <br /> 1. ENVIRONMENiAL CHECK LIST PENA�n. U 8 C <br /> 2. BUILDING PLANS SEC.3031a) <br /> 3. F�RE HYDRANT TOTAL <br /> 4. FIRE PROTECTION SYSTEM PEHMIT VALIDATION <br /> WHEN PROPERIV VALIDATED pN TFIS SPFCE)TH1515 YOUR P[RMIT <br /> 5 GRA�ING <br /> . �' <br /> fi. DRAINAGE _ OQ2 � � OO �, rJ O —� <br /> 7. ENVIRONMENTAL Ih1PACT STATEMEN7 <br /> B HEALTH DISTRICT � <br /> APPLICATION ACC �Y P�AN$CHECKED BY APPR.fOR IFSUANCE BY � � � � �r- � <br /> ,� :C; � I Pl' <br /> , , � <br />