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d�cE�rrgrcen rONSTRUCTION - <br /> CITY OF <br /> ever�tt PERMIT PERMIT NO. 0943�. <br /> CITV HALL 259-874$ <br /> eveaerr,v✓n �szo� � COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> O1YNlR MAlIAppRE55 Qtt piP pNONE <br /> 3sa—i �an <br /> nHC11rtECTORpL4GULR M4:LnD RES, QiY 21P CIION[ <br /> GENERAL CONiRAC10R Mt'L AODRE55 CIiY ZIP C�IONE LICENSE� <br /> SBLF <br /> ME6HAYiCA�('pNiPACiOR Mi.IL qDDRE55 UiV ZIP PMONE LICENS[I <br /> �',Ut'E11tiGCONiRALiOR MMLA�pRE55 CI1V ZIP PI!ONE LICELSEI <br /> G OP WOPK ! <br /> ❑NEW �]4DDITION ❑ALTERATION ❑REPAIR ❑DEMOLITIOt� ❑FENCE ❑SIGN ❑GAqAGE � <br /> _AiION OG WONK <br /> 5400. 00 <br /> �ESCPiL�E WORK <br /> BATHROOM ADDITION <br /> FRoroSEo usc oF eWLOINc <br /> SINGLE FAMILY DWELLING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP� <br /> iecniocscairnor+oFvrrorearris��owoeiowcanrrncr�rouncoPies� PLICATION AND KNOW THE SAME TO BE TRUE AND CORPECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> �o� � e�.oc�_.or BEVERLY HODIE3ITGS NQ,_L 7YPE OF WORK WILL BE COMPLIED WITH WH[THER SPEGFIED <br /> HEREIN OR NOT. THE GRANTING OF A PEFMIT DGES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLA?:OR CANCEL THE PRO- <br /> VISIONS OF ANY OTHEA STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUGTION. <br /> JOHADDRE55 iiG114tUREOFGONTRP�CTOPORhl1iNORiZL�AL'Epi Dni[ <br /> 7708 UPPER R X ✓ �ii-,r/� � <br /> PLUMBING MECFiANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> 1 VlATER CLOSET�TOILEi) O__ iJR COND UNITS—HP.EA <br /> ]. �ATHTU� R@FRIGEfiATION UNITS—N P.EA <br /> WVATORY pYASH BASIN� 0 a �OILERS—H P.EA. <br /> SHOW[R 2 00 GASFIHEDAC UNITS—TONNAGEEn. <br /> KITCHEN Slh�(8 DISP. FORCED AiR SYSTEMS—BS.U. M EA. <br /> DISHWASHER WALIHEAiEPS—BS.U. M <br /> LAUNDRY TFAY UNIT HEATERS—�TL. 1d <br /> L CLOTHES WASHER EVAWRATIVE COOLERS <br /> WA�ER HEATER CLOIHES DRV[RS <br /> IIRINAL VENTILATION FAN <br /> DRINKING FOUNTAIN FANGF.HOOD <br /> PLOOR DRAIN Alft HANDLING UNIT— CF.M. <br /> VACUUM OREAKERS SIuvE <br /> ROOF DRAINS—t7AINLEADERS � METAI FIREPLACE 8 CHIMNEY <br /> SINK�S[RVIC[—9AR,ETCJ <br /> SUBTOTAI � SUBTOTAL F <br /> PERMIT S PERMIT S <br /> TOTAI FEE S ]_O TOTAL FEE S <br /> SiU6 y'�RD SETbACK STPEET SE'.l3�1CK REAR 1'AR�SEiBACK PIAN CHECK NUM�ER PIAN CHECK FEE <br /> 6 ft 20 ft 20 ft 81/9931 F« 36 . 73 r�EceiPTNo. <br /> u,czoNF �oraaE�. vacnN?siTc 54076 <br /> I_vES I:NO FEES VALUATION PEE <br /> TYPE OF COYSL OCCUPANCY G90UP NO.OF DWELCNG UNITS <br /> �UIIDING 5 <br /> SIZE OF BLUG ND.OF STORIPS MAR. C.LOAD � ° <br /> l Svl A � PLUMBING lO OO <br /> t IP.i.,'JN6 BASE NT FIRE SPRINKl6R3 <br /> F[OUIRED M[CHANIGAL � S O <br /> fiYES .1N0 <br /> APPROVALS BY DATE OTNGR ( <br /> L ENVIRONMENTAL CHECK LIST U�C �' <br /> PENALiY SEC.303�a) <br /> 2. BUILOING PLANS <br /> 3. FIRE HYDRANT . TOTAL <br /> <. FIRE PHOTECTION SYSTE�yt PEflM1T VAUDATION <br /> \VFEN PROPERLY VALIDATE�(IN THIS SPACE)THIS IS 1'OUR PE(7h11T <br /> 5, GPADWG " <br /> I. / r � <br /> G �flAINAGE ' � " � ' � <br /> i � <br /> ?. ENVIRONMENIALIMPACT$TATEMENT . '� <br /> � .P. HEALTH DISTRICT � . . - " ' � <br /> �_ . � . i , i (� <br /> APPIICATION ACC.OY '�LANS CHECKED�Y APPR.FOR ISSUANCE BV . � <br /> 1-_ 59 VC lp � <br /> I <br /> :,1 ADDrE55 FIL�: � <br />