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thp ErertreCir <br />evere�t �� i�ONS'�RUCTI�� . <br />CITVHALL259-8745 PERMI� PERMII' N0. ��94L <br />EVERETT.VJA98201 ❑ COPABINATIO�' J� BUiLDING ❑ MECHANICAL ❑ PLUMBING <br />JV�NER <br />h1RS. LEOA'ARII SQUIRE 44k��9-98� EVERL-TC i4p°��2p1 ='P P�o�e <br />ARGMITECT OP DESIGNEF IdaIL ADD9E55 CITY ZIP PYONE <br />GEN[RNL WNTRAGTOR 1.1AIL AODPESS CITY ZIP PMONE UCENSE M <br />Same <br />MECMANICAL GONTRACTOR MAI� ADDRESS CRY ZIP PMONE LICENSE / <br />PLUld81NG GONTflPGiOR MA�I AODRESS GTY IIP PHONE �ICENSE X <br />❑ NEW ❑ ADDITION ❑ ALTERATION �I' REPAIR C] DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVFJFIREPLACE INSERT <br />E 65�.�� <br />Reroof <br />Residence <br />LOi �y�roI�GN _.1_OF <br />44�6 Hoyt <br />PLUMBING <br />N0. TYPE OF FIXTURE OR ITEM FEE <br />BATHTUB <br />LAVATORY�WASHBASIN� <br />_ SHOWER <br />KITCHEN SINK S DISP. <br />DISHWASHEfi <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />WATER HEATC-R <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR DHAIN <br />ROOF DRAINS — fl?.INLEADERS <br />SINK �SERVICE — BAR, ETQ) <br />SUB TOTAL <br />PEHMIT <br />TOTNLFEE <br />SIDE VARD SETBACK STREET SETBA <br />USE ZONE LOT AREA <br />TVPE OF CONST. OCCUPANCY G <br />SIZE OF BLDG. NO. OF STORIE <br />FIRE I.ONE BASEMENT <br />APPflOVALS <br />1. ENVIRONMEN7AL CHECK LIST <br />2. BUILDING PLAWS <br />3. FIRE HYDRAN f <br />4. FIqE PflOTEC'�ION SVSTEM <br />5. GRA�ING <br />6. DRAINAGE <br />�.ENV'90NMENfALIMPACTSTATE1dENT <br />B. HEALTH DISTRICT <br />� <br />5 <br />5 <br />REAR YARD SETBA <br />VACANT SITE <br />�:YES I �.P10 <br />NO. OF DWELLING <br />1dA%. OCG LOAD <br />FIRE SPqINKLERS <br />REOUIRED <br />�. �YFS :- NO <br />BY DATE <br />BY �APPR.FORISSUANGE BY <br />I HEREBY CERTIFY THAT I HAVE READ ANU EXAMINED THIS <br />APPLICATION AND KNOW THE SP.ME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDI,^.'ANCES <br />GOVE7NING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHEI"HER SPECIFIED HEREIN OR NOT. 1�HE GRANTING OF A <br />PERMIT DOES VOT PRESUME TO GIVE AUTHORITY TO VIOLP.TE <br />OR CANCEL THE PROVISiONS OF /1NY OTHER STPTE ��F <br />LOCAL LAW �CGULATINC CONSTRUCTION OR THE <br />PERFORMANCf OF COIJ:TRUCTION. <br />SIGNATURE 0` CONTitACTGR OR AU�i HORIZ[j) AGEN'" pA7[ <br />X �i=5.v/�c�e-rrah.0 <�'�F�-�-���lv: h/6/85 <br />MECHAN�CAL •- <br />TYPE OF E�UIPMENT <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION 1:NITS — I1.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNiTS — TONNAGE EA. <br />FORCED AIR 5"STEMS — B.T.U. M EA. <br />WALL HF4TER5 — B.T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPURATIVE COOLERS <br />CLOiHES DRYEfiS <br />VENTILATION FAN <br />RANGEHO00 <br />AIR HANDLING UNIT — QF.M. <br />5T0�'E — WOOD <br />METAL FIREPLPCE & CHIMNEV <br />FIREPLACEINSERT <br />HEAT PUMP <br />CHECK <br />SUB TOTAL <br />PERMIT <br />TOTALFEE <br />FEE <br />f <br />S <br />5 <br />RECEIPT NO. <br />FEES � VALUATION I FE� <br />BUILDING �� 13 �� <br />PLUM1IBING <br />A7ECHANICAL <br />OTHER <br />PENALTY <br />TOTAL I I lz �� <br />PERMIT VALIDATION <br />VJHEN PqOPERLY VALIDATED QN THIS SPACE) TMIS IS YOUflPERM1T . (�� <br />� _ �i <br />� <br />�� <br />[_'i <br />ADDRE55 1=1LE <br />