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F,,P/B APPLICATION FOR eVP,P„ <br />YCONSTRUCTION.:) <br />;verett PERMIT <br />01111 UI COMMUNITY DEVELOPMENT SERVICES <br />('IIY IIALI. 2598745 <br />FVIRFIT. WA9R2B1 ❑COMBINATION ❑ BUILDING MECHANICAL ❑PLUMBING PERMIT NO. <br />IIW.IR AIAII AUVRFSS CI11 71P PHOM <br />AHl llllllll)R III (II:NIN KIAII AUUN155 CITY LEI' f110N1 <br />�f�a/(�ri' /M� v��/Fo/2/z�(yer/ weJf Z S/f�•r,•a.b s� d, r.>S 9�00 `f 2 o C- 5�3"s-3SS� <br />NIRAI II I/NAf 1U/R { A —All AUURI SS IY TIPc f110N[ llCl rv$1 N <br />rC�@ [�/.'T /3oo .��i:4 S1 Se¢��/ u/c.. /tea �e y In iS�•�3.73 <br />Alll I IIII M IONINAl1UR AIAR AUURISS CITY LIP PHONI MINIS( OF <br />al,,4._R,7el--A4- /35�9 Xororq,/vef�• Sea ras 9�/33 3GY �iyo <br />rm.nuNr. u)NIxAC Iu -1 AI: AnURISS arr 7 V11 MONT UCINSII <br />N5 11 NK <br />� IOIyN(I❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑Il U1LDING RELOCATION <br />Y\IU&IION OI Y\URK <br />1 <br />I IIS(ITT "'IRK <br />/7 6 <br />"i,—•/!/ry K­W V <br />r«orolnl LI OI RuI.Ir7 !! f� / <br />/ / ! <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />SAME TO BE TRUE AND CORRECT ALL <br />Sw /i o.y: J'/I le .sir%Y UP 7� <br />Y'"✓2 f�'�' LT, <br />PLICATION AND KNOW THE <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />IIC" ❑NI NIP)ION OI PROPI RIY ISIIONN 1, as A1IACII IOUR COPIES) <br />2J I%i La <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />non!Le Evere/f <br />IRn,p_, e %/riOl <br />�l & S <br />OR NOT. THE. GRANTING OF A PERMIT DOES NOT PRESUME TO <br />F+if A��; M y o E✓er C%t d or c%nq 7(o <br />c <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />✓o// <br />a /` <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />OR AUTHORIZED AGENT DA1[ <br />rC Co r clS o y SrLo /jowl.:Fl <br />SIGNATURE Of CONTRACTOR <br />X <br />TOR ADDRI SS ji <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />N'AII R I TOM TTOO I t 11 <br />AIR COND UNITS—IIP [A <br />IUIIIIUII <br />REFRIGERATION UNIIS—II9P EA <br />/ <br />-- <br />IM'ATORY(WASIIBASIN) <br />BOILERS—IIP EA •N o.A V <br />O <br />S110%%1IT <br />GAS FIRED AC UNITS-70 NAGEIA <br />KIICIU N SINK A LISP <br />FORCED AIR SYSIEMS—B T.0 M EA <br />DISWASIB R <br />WALL II EATERS—B 7 U M <br />I AONURY TRAY <br />UNIT IILAHR5—B7U M <br />(101111 S WASHER <br />EVAPORATIVE COOLERS <br />CLO7111S DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING IOUNTAIN <br />RANGE HOOD <br />HOUR DRAIN <br />4 <br />AIR HANDLING UNIT— C F Al Y"7_ /J e•s <br />SS <br />VACUUM BRI AKI ITS <br />STOVE <br />ROUT DRAINS —RAINLI AT)[ RS <br />MTEAL FIREPLACE A CHIMNEY <br />SINK ISI RVICL—BAR, I IC I <br />3Vj <br />ATt2 EATr. <br />O <br />cc f <br />a <br />SUB TOTAL <br />SUB TOTAL S <br />/ 11 <br />PERMIT <br />S <br />PERMIT S <br />O <br />TOTAL FEE <br />S <br />TOTAL FEE F <br />J <br />A� <br />SIDE YARD SO I LACK <br />STREET SETBACK <br />REAR YARD SETBAC11 K <br />PLAN CHECK NUMBER <br />PLAN <br />CHECK FEE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT S17E <br />TEES <br />VALUATION <br />FIF <br />OYES ONO <br />IYPE Of CONS) <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />BUILDING <br />S <br />SIZE 01 IILDG <br />NO OF STORIES <br />MAX OCC LOAD <br />i. <br />1'LUNIIIINC <br />I IRE LUNI <br />BASEMENT MEN) <br />III UROUn6 <br />TIRE SPRINKLERS <br />REQUIRED <br />MECIMNICAL <br />rim ONO <br />APPROVALS <br />BY <br />DATE <br />OMER <br />1 ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.BC <br />SEC. 30)(a) <br />2 BUBUING PI ANs <br />TOTAL <br />1 11111 IIIDRANI <br />a FIRE PROI(CIIONSYSTIM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED TIN MIS SPACE) MIS 15 YOUR PERMIT <br />' <br />5 GRAUINGI M AVAI ION A Cl I ARINGIGRU11111NG <br />6 DRAINAGE <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />B I IIALIIIDISIRICI <br />APPLICAIIONACC. BY <br />PLANS CHECKED BY <br />APPR TOR P IUANCI BY <br />91 71) <br />