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�h� [crr¢rren <br />everett <br />CIiV HALL 259-H7a5 <br />� ^��s-r�ucr�or� <br />P�RMdT PERMIT NO. �5�� R <br />EV[He'TT. V!A 9d201 �� CONBINATiON � BUILDING � MECHANICAL � PLUMBING <br />��rNtH MAIL AOpRE55 ` �ItY ZIP PMONE �_ <br />Harmon and Assoc. P.�. Box 1179 Sta7wood 9829? 629-4536 <br />ARC.IRECi OR DESIGN[R M41L AOP9C>5 CITY Zlo FHONE <br />GENER6L C011THACiOR MAIL AO�RE55 �ITY ZiP PNONE LiCENSE Y <br />Same <br />MECMANICAI CONTFAQOR MAIL AOORE55 LITY (�p PMONE UGFNSE Y <br />PIUMBINGWNiHALiUR MAItADDRE55 CITV ZIP PHONE LIGENSE� <br />❑ NEW ❑ ADDIT�ON C ALTERATION ,�` REPAIfl ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLAGE INSERT <br />s 1500.00 <br />re-roof composition <br />Office <br />�o* 8 e�ocrc 22 oF Replat oi South Pazk <br />J09 AODPE55 <br />4z02 Hoyt <br />PLUMBING <br />NO. TYPE OF FIXTURE OR <br />VlA7ER CLOSET �70ILEn <br />BATNTUB <br />SHOWEF <br />KITCHEfJ SINK 8 DISP. <br />DISHWASHER <br />LAl1NDRY TRAY <br />CLOTHES WASHF^ <br />WATER !ICATER <br />UflINAL <br />ORI�KING FOUNTAIN <br />FLO011 DR.GIN <br />VACUUM BREPKERS <br />p0! �F UHAINS - RAINLEADERS <br />SIN ( (SEflVICE - BAR, ETC � <br />1 IAE ZONE <br />SUB TO7AL <br />PERMIT <br />TOTAL FEE <br />'A.OF <br />APPHOVALS <br />1. EMVIRONM�NTAL CMF.CK LIST <br />2. BUIIDINf PLANS <br />�. FIRE H` JNANT <br />a. FIRE •ROTECTION SVSTEM <br />5. GFADIIVG <br />fi ��flAINAGE <br />i.ENVIRON�NFNTALIMPACTETATF.MENT <br />B.MEALTH DISTRICT <br />5 <br />S <br />S <br />VACANT SITE <br />YES , NO <br />NO. OF DWEL <br />BV <br />i HEREBY CERTIFY THAT I HAVE REaD AND EXAMINED THIS <br />A?PLICATION AND KNOW THE SAf,AE TO BE TRUE AND <br />CUFRECT. ALL PRVVISIONS OF LNWS AND OFDINANCES <br />GOVERNING THIS TYPE OF VJORK W!lL 9E COfAPL1ED WITH <br />WHETHE�� SPECIFIED HEREIN OR NCf. 1 iiE GFANTING OF A <br />PERMIT DOES NOT PRESUME TO GIbE AUTHOh'f-Y TC VIOLATE <br />OR CANCEL THE PROVISIONS JF ANY OTHEH STPTE OR <br />LOCAL LAIV REGULAT� CONSTRUCTION OR THE <br />PERF',ORMANGE OF CONSTFdCTION_ <br />VGN � OF CqNyHFy7g UT'�ORI ED AGENT DATE <br />A C/�.G-Z�i ��� FO�G .ii,�,U . 10/2/85 <br />N0. TYPE OF EOUIPMENT <br />AIR COIJD. UNITS - H.P. EF. <br />REFRIGER4TION UNITS - H.P. En. <br />BOILERS - H.P. EA. <br />GAS fIRED A.C. UNITS - TONNAGE EA. <br />FOACED Alq SYSTEMS - B.T,U. M EA. <br />_ i WALL HEA�ERS �- B.T.U. M <br />UNIT HEATERS - B.T,U. M <br />EVAPORATIVE COOLERS <br />CLOTH'c5 DRYERS <br />VENTILA7iON PAN <br />RANGEHUCD <br />AIR HANDLING UNIi - C.F.M. <br />S70VE - WOOD <br />METAL FIIIEPLACE & CHIMiIEV <br />FIREPLAC = INSERT <br />� HEAT PUh'P <br />SUB TOTAL S <br />PERMIT S <br />70TAL FEE 5 <br />�E�BACK PLAN CFIECK NUMBER PLAN C. <br />FEE <br />FEES VALUATION <br />LING UNITS <br />BWLDING i��o.00 <br />!AD — _ <br />PLUNBING <br />.c'�:', MECHANICAL '--- <br />DATE �THER <br />8V �APFR.FOR dSUANCE BY <br />PENALTV <br />� <br />: ;J <br />FEE <br />RECEIPT NO. <br />FEE <br />TOTAL I I ZS I <br />PEflM1T VALIGATION <br />WHEN PROPERLY VAi IDATED �IN THI$ JRA�E� TH13`Iy�VQ� Fj�i�AIT <br />� JUL UU <br />ADDRF55 FlLE <br />,.: ,. cr-irT . <br />i� <br />. . , .,. i��. � <br />... '1 �'�. � U � <br />� <br />