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• � , <br /> 1heErergreen �' �p�r-�TRUCTION � <br /> Clir OF <br /> everett �ERMIT PERMIT N0. 06219 <br /> CITY HA�L 259-8745 <br /> eveaerT.wn �ezoi ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL � PLUMBING <br /> OWNEN MA4AUDHFS$ CIiV ZII' PIIONE <br /> Dr. Drumheller <br /> ARCNITCCI OR D[SiGNLN NAIL RDDRESS C11Y ZiP PMONE <br /> GEN9FALCAHTRAGTOR MAI�ADDRE55 CITY ZIP PHONE ULENSE� <br /> MfCHANiCPLCANiPACiOR M�ILApDRE55 CITY LIP PNONE IICENSE� <br /> PWNdINGCANiPAQOB MAILADORC55 GiY IIP MONE L�G[NSE� <br /> Rucker Avenue Plumbi.ng <br /> CIASS OF WORK <br /> ❑NEW ❑ADDI70N ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> VAI.URTION OF WORK <br /> S <br /> OESCNIBE WOPK <br /> PROPOSED USE OF BUILDING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP <br /> ieGn�oEscaia.iorvnFvaoaenrvisHowee�owoannncNFouncoaies� PLICATION AND KNOW THE SAME TO BE TRUE AND COFRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING 1 HIS <br /> io� aice�oc TYPE OF WOPK WILL BE COMPLIED WITH WHETHER SPECIFlED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br /> VISIONS OF ANY OTHE TAT OR LOCAL LAW REGULATING <br /> 3 a CONS R TIO 'OR T RF ANCE OF CONSTRUCiION. <br /> eoaaooaess � s�r�ni coi� croa �+oaiz ecHr S�Tf 4/79 <br /> 1S2�S'-PaaiYic (2n rloor) X <br /> PLl�M81N3 ME HANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF E�UIPMENT FEE <br /> WATER CLOSEi(TOILEn � AIR COND.UNITS—H P.[0. � <br /> BATHTUB HCFRIGC47AT101!UNITS—HP EA <br /> 9 LAVATORV(WASN BASiN) 8 OO �OLLLf15—H P.EA. <br /> SHOIVER GAS FlRED AC.UNITS—TONN4GE EA. <br /> 1 KITCNEIJ SINK 8 DISP 2 OO FORCED Alq SVSTEMS—9.TL. M EA <br /> �ISHWASHER V✓ALl HEATERS—�TL. M <br /> LAUNDPY TRAV UIJIT H[ATERS—B7.U. ti1 <br /> CLOTNES WASHER EVAPORATIVE COOLERS <br /> WATEfl HEATER CLOTH[5 ORYERS <br /> URINAL VFNTILATION FAN <br /> CRINKING FOUNTAIN f7ANGE HOOD <br /> FLOOR DRAIN AIR MANDLING UNIT— CF.M. <br /> VACUUM BREAHERS STOVE <br /> ROOF DFaINS—FAINLEADERS METAL FIREPLACE 8 CHIMNEY <br /> SINK(SEFVICE—BAR,ETCJ <br /> SUB TOTRL 12 O O SUB TOiAL f <br /> PERMIT f 00 PERMIT f <br /> TOTAL FEE S 00 TOTAL FEE S <br /> SIDE VARD SETBACN STIiEET SET�4CK flEAR VARD SETBACK PLAN CHECK NUMBER PLAN CH[CK FLE <br /> FEE RECEIPT N0. <br /> � USE ZONE lOT APEA VACANT SITE <br /> ❑YES ❑NO FEES VALUATION FEE <br /> TYPE OF CANST. OCCUPANCY GROUP N0.OF DWELLING UNITS � <br /> BUILDING S <br /> SIZE OF BLDG. NO.OF STORIES MA1(.OCC.LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS <br /> REOUIRED MECHANICAL <br /> IIVES flNO <br /> APPNOVALS BY DATE OiHEF <br /> � 1. ENVIRONMEN7AL CHECK LIST pENALTY U 6.0 <br /> 2. BUILDING PLANS SEC.303(9) <br /> �� TOTAL <br /> �•-- -3.�FIHE HY�RANT <br /> ' . —� <br /> � y a. FIRE PROTEC710N 5 M PEHMIT VALIDATION <br /> . WHEN PROPERLV VAUDATED pN THIE SPACE)THIS IS VOUH PERM;T <br /> 5. GR <br /> , +� atoa tQ 11.00 �--�-6'3 <br /> 7. ENV NW�ITAL IM»T STAtEMENT (V <br /> e � pPPLI:.(�10�'C OV � PLANS CHECKED 8Y APPR.FOR ISSUANCE BY , YO U R R EG ElPT� �� <br /> r O w► � i'�1Nt� Y�?L . <br /> c. . , � �' <br /> --' � ; . � ' <br /> `�'� ADDRESS FILE ' ' i . � 7 � 79 <br /> j _. . _� _ � . <br />