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� <br /> rnr Ecr.e.ri�,� <br /> ever�tt � �O �STRUCTIO [�� <br /> ���� �� PERMIT N0. 1 � ;.• il , <br /> CITV HALL 259-P7.5 <br /> e�eaeTr.�va 9azoi IX] COh181NATI0N XJ BUILDING �X' MECHANICAL l� PLUMBING <br /> OWNER MFR ADDRE55 CITY ZiP AIONE <br /> ;� Clif£ Counley =506 Jackson Everett qe�n'� 355-7169 <br /> ARCMIiWiORDE5IGNEF MNILADORE55 GRY ZIP PMONE <br /> GENERAL GONTfll.CTOR MAIL FODFESS CITV ZIF PMONE IICEIISE• <br /> Same <br /> MEGHANICAL CONTRAGTOR MAIL NO�RE55 CITV ZIP PMONE LICENSE I <br /> PLUMBING CONTRALTOR IAAIL FOORE55 CITY ZIP PHONE LIGENSE� <br /> CLA55 OF WORN <br /> ❑ NEW �MDOITION ❑ ALTERATION ❑REPAIR ❑ DEMOLITION O FENCE ❑ SIGN ❑ WOOD STOVEIFIFlEPLACE INSERT <br /> VAW/+TION OP WOPN <br /> s 23,127.00 <br /> DESCRIBE WORK <br /> Extend living room and build two Bedrooms Second <br /> PROPOSED USE OF BUILOING <br /> gingle Family Residence I HEREBY CEPTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME i0 Bc TRUE AND <br /> LEGFLDESCRIP�IONOFPFOPERTY�SMOWBELOV/ORATTACHFOURCOPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> �or 17 e�ocK 40aF Pinehurst Div C GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRAN'iING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHOFITY TO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANl' OTHER STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PEHFORMANCE OF CONS�fRUCTION. <br /> JOB ADDRESS SIGNATURE OF CO iFACi F 4t1iMORIZEO AGENT DAtE <br /> 2506 Jackson X __� <br /> PLUMBING MECH AL <br /> NO. TYPE OF FIXTURE OH ITEM FEE NO. Ti PE OF EQUIPMENT FEE <br /> WATERCLOSET�TOILEn AIR COND. UNITS – H.P. EA. <br /> gq7H7�g - REFRIGERAiION UNITS – H.P. EA. <br /> LA'✓ATORY(WASH BASIN) BOILERS– M.P. EA. <br /> SHOWER GAS FIRED A.C.UNITS –TONNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS– B.T.U. M EA. <br /> DISHWASHER WALL HE4TERS– B.T.U. M <br /> LAUNDRYTRAY UNIT HEATERS– B.T.U. M <br /> CLOTHES WASMER EVAPORATIVE COOLERS <br /> ' WATER HEATER CLOTHES�RYERS <br /> UFINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT – C.F.M. <br /> VACUUM BREAKERS STOVE –WOOD <br /> ROOF DRAINS– RAINLEADERS METAL FIREPLACE 8 CHIMNEY <br /> SINK�SERVICE– BAR,ETC.) FIREPLACE INSE'1T <br /> HEAT PUMP <br /> SUBTOTAL S 6 00 SUB70iAL 5 3 00 <br /> __PEHMIT f PERMIT S <br /> TOTA�FEE 5 ( TOTAL FEE f 3 OO <br /> �IDE YARD SETBACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> 5' � ; 20' � 84/13291 FEE 106.93 6'����Pr No. <br /> USE ZONE LOS:AREA VACANT SITE FEES VALUATION FEE <br /> _ R'Z , . . c� . YES R7N� � - <br /> jYPE OF G�NST. UPANCV GROUP NO.OF DWELL'NG UNITS _ <br /> �-�� V-N�� � - d'n Alter R 3 1 BUILDING E 23,127. 164 50 <br /> SIZE OF�LOG: -� N DF STORIES MAX.OCQ LOAO <br /> � 192 Sq. Ft. A�dd' 2 PLUMBING _ G 00_ <br /> . PIRE ZON[ 095EMENT FIRE SPRINKLERS MECHANIGAL 3 Be <br /> REOUIREO <br /> - ' pOne .VES D <br /> � APPPOVALS BY DATE OTMER __ <br /> 1 ENVIRONI.,�NTAI CHECK LIST PENALTV U.B.G. <br /> SEC.303 WI <br /> 2BUILPINGPLANS - TOTA� ].�j O <br /> 3.FIREHYDRANT "' <br /> d.FIRE PROiECTION SVSTEM y PERMIT VALIDATION <br /> — — WHEN,PR�PERLY,VALIDATF,.�pNTH iSPA E)THI3�1 YP RijEflMI� � <br /> S.GRAOING � � I L – ��I � � y � �.�}, {; �I , � <br /> 6.DPAINAGE � `� . _ . . . . '� <br /> J 7.ENVIRONMENTALIMPACiSTATEMENT <br /> B:HEALTH DISTRICL i.�.i - � - ' � , , �� I� j � � <br /> AGPLICATION ACC.0V �PlANS CMEGKED BV APPR.FOR ISSUANCE BY � � i i I ' ��' <br /> I <br /> � � STG � ' 9WM LC � <br /> � <br /> . . ..� _. _. � ',I.i . , <br /> � <br />