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`,"`""'`�`�" � � CONSTRUCTIOfV � � <br />���g�t� PERIWIIT PERMITtJO. GG�JGIr� <br />�� <br />i r.,, . I_J COMBINATION �xl BUlLDING �� MECHANICAL IJ PLUMBING <br />..._ 1.!niLALLP��y [I1V bP PrIJ1lF <br />John W. Baton 60C9 i4cDougal 98203 355-6009 <br />.�. �:qFC*oRDEsiGNLn ieMLnn[mibs - cir� LP rl�ou: � <br />,' �Al CONTa4Ci0R MAI� ADpRE55 CITY JIP VVIONE d" �'�� <br />' �Same ' <br />...��tNICALCONiRACiOFi 1,1AiLADDRESS CITY 21P PHONE t�5�.'..,. <br />,!�ABIN6CONiRAGIOR MAILAODRE55 CIiY ZiP PHONC UCFt9 <br />- . ��JS Uh \YUNM1 <br />❑NEW ❑AD�ITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SiGN ❑GARAGE <br />;:.�, U;aiON or �YORK <br />s 1800.00 <br />fl �CNiBC \40RK <br />10—YOOf <br />. ,_ � orm usE or em�o�uc <br />single family residence <br />��.0 oescr+irnou or raor�nrv is��o�:� eeiow Dn nttnc�� voua w <br />140CY_OF <br />5-28-5 Replat of Pinehurst Div. A. <br />6004 ��I�]cDougal <br />PLUh181NG <br />N0. TYPE OF <br />AniHTUB <br />LAVATORV �IYASH I <br />SHOWCR <br />KITCHEN SINK 6 D <br />DISIINASHER <br />LAUNDRYTRAY <br />CLOTNES WASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTP <br />FLOOR DRAIN <br />VACWRI �R[ANER <br />ROOF �RA W 5— R <br />SINK IS[RVICF —! <br />Stl'E PAPD SE7HnCK <br />i �5L ZONE <br />iYP <br />i:i <br />{ I�iE ZONE <br />OR <br />SUBTOTAL <br />57REET SETdACK <br />LOT AREA <br />OCCUPANCY GROUP <br />NO. OF $TORIES <br />� EtlViHONMENTAL CHECK LIST <br />CIUILDING PLANS <br />;i f i17L HV�HARi <br />.: I IRE PROTECTION SYSTE61 <br />' t3RADING <br />r DHAINAGE �� �... <br />kI1JVIRONMFNTAL RdPPCT STATEMENT <br />-'-== - � �;,, � -- <br />;,���,�i�,�.:��,-. �scHECKeoov <br />-- —� � --- <br />I HEREBY CERTIPY THAT I HAVE RGAD AND EXAMINED THIS �P- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT <br />ALL PROVISIpNS OF LAWS AND ORDINANCE£ GOVEFNING TFiiS <br />TYPE OF VJORK WILL BE COMPLIED VJITH WHETH[R SPECIR[U <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GNE AUTHORITY TO VIOLATE OR CANCEL THF Pi �O� <br />VISIONS OF ANY OTHER STA7E OR LOCAL LAW REGULATICIG <br />CONSTRUCTIC'^' OR THE PERFORMANCE OF CONS7RUC.TION <br />•;c,� ca..� r.,rrqn�n�oTu,i��� +a!�a i�:.r: <br />�� �/�,�,, <br />X i� %i'� �C,It.G'y" iniin[�n <br />7 <br />FEE NO. TYPE OF E�UIPMENT <br />NRCONu Uwts�-Ha Fa <br />REFRIGERATION UNITS — H P EA <br />�OILERS — H P EA. <br />GAS FIREU A C UNITS — TONNAGE EA. <br />��ORCCD AIR SVSTEMS — d.T U. M EA. <br />Nr��L HEATERS — B T.0 A7 <br />�NIT H[ATERS — B7 U. A. <br />EVAPORATIVE COOLERS <br />CLOTHES OFYEf75 <br />V6NTIlAiION FAN <br />RANGEHOOD <br />AIR HANDLING UNIT <br />STOVE <br />METAL FIPEPLACE & CNIAWEY <br />FIi�R YARp $ETUACK I PLAN <br />i�YES i:�NO <br />NO.OF DWEILIN( <br />n+nx occ �ono <br />FIRE SPRINKLERS <br />ntoum�o <br />;'.VES :iNO <br />HY DATE <br />SUB TOTAL <br />PERMIT <br />FEE <br />�10ER PLnN CHECH PEE <br />FE[ HF.�EIP7 NO <br />FEES VALUATION FEE <br />UNITS <br />BUILOING 5 1800.00 18 00 <br />PlUM81NG <br />IdEC4ANICAL � <br />OTHEF <br />PENALT'/ U B C. <br />SEC 903 WI <br />70TAL 16 00 <br />PERMIT VALIDATION <br />PJHFP: � POPi:{�J� V;,I.IDn1L'D,IN iH15 SI-.4�.EI iHIS IS 1'OUR PLRh11T <br />- 33�7 Q� Tt�.�� `Y�, f � <br />�_� <br />';'::>U : RECEli T; <br />4PPP ! t,�q I`.i.�Ui�IJt �_ �3Y . . � q A! � ;.� <br />i I�1 i l:l�� I�� <br />� � ��� � U <br />�_I � ( <br />