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, <br /> _ � <br /> � <br /> -1 <br /> `''`'`'""';'��� �'ONSTRUCTION <br /> ev�rett PERMIT pERMIi No. 1i506 <br /> �„Y �,�«<5�d,.,� <br /> � !vt:r��n v:n nnr�,� ❑ COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING <br /> U�:tllli M➢�Lrll'111iL1S GIIV ZIV 1'IICFC <br /> ROIiBRT VANKGRGTIiR 1908 RUCKGR EVIiR8T7' <br /> <qCwILC109pfSGN�11 MAiLAUDPCS. Cil� ➢P PIIOtlE <br /> GlN6i4lfC41RnCiOR MnIL��DAC55 LiIY IiP PHONE IICCMSE� <br /> CUSTOG5231PG <br /> � f.•IOIA.L'4L(�NtRA.,IUN MAIIADpRC55 OtY jIP FNONE �ICCNSF� � <br /> Custom Gas 22329 - 57th SI: 13othe1l 98011 481-5515 <br /> �WI.IOiNGCOhiRAQOR MAIIADpPFS GIiY $IP PNONE LICENSEI <br /> GlA55OF WORK <br /> �' NEW ❑ADDITION ❑AL7ERATION ❑REPAIR ❑DEMOLITIO`� ❑FENCE ❑$IGN ❑GnRAGE <br /> Y4WALION O[WORM1 — <br /> L <br /> UCSC�IPE WORK <br /> Conversion Uurncr <br /> r��orrosto ust or omioinc <br /> I HEREBY CEFTIFY THAT I HAVE RE�D AND EXAtdWED THIS AP� <br /> i[cr.�oescnivtiorvovvnovcHrr�s�owonowonnnar��rouuccrics� PLICATION AND KNOW 1HE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF IAWS AND ORDINANCES GOVERNING THIS <br /> ior mec�_or TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OH NOT. TNE GRANTING OF A PERMIT DOES NOT <br /> _ PRESUME TO GIVE AUTi10RITY TO VIOIATE OR CANCEL THE PRO� <br /> VISIONS ANY OTHER STATE OR LGCAL LAW REGULATING <br /> CONSTFlU TION OR THE PERFORMANCE OF CONSTRUCTION. <br /> doovooacss ���.��r���� . mr�no.r*o��oanuuroAamn oni� <br /> isos au��;�r x .�d ,�'�'�,CQ`� 2/in/as <br /> PLUMBINO M HANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE N0. TYPE OF E�UIPMLIIT FEE <br /> WATE9 Cl0$[T QORETI AIR GOIi� UNRS—M^.FA <br /> BATIITUB pEfRl�[FATION UWITS--M P (4 <br /> LAVATORY�FYASH BFSIN� UpILER$—11 P EA <br /> _ SHOWER GAS f IqFI!�C UNiTs—iONNnGE En <br /> KRCH[N SINK R OISP. FORCED AIR SYSTE!!S—B i U M EA <br /> UISMWASNEF �9ALLH64ilR5—BTL M <br /> LAUNDRV TP�v �Nli��f 4iER;—0 i U M <br /> Cl01HE5 WASN[N EVA4'ORAiN6 COOILRS <br /> 1YATER MEAiER CLOiNES DRY[q5 <br /> UFINAL VENiI:ATION FAIJ <br /> URINKING FOl1NTAIN RANGE MOOD <br /> FLOOR URAIN AIR NqNf1LING UNIT— C f.M <br /> VAGUUM BRCAMERS S10VF <br /> ROpF DRAINS—RAINLEPOERS MEiAL FIpEPLAGE 8 CHIMNE'! <br /> _ sir+K�seawce--onn.erc� 1 Conversion Uurner 4 50 <br /> SUBTOTAL SUBTOTAL S ( <br /> PERMIT f PERMIT S 1Q O� <br /> TOTALFEE f TOTpLFEE f <br /> SIDE VPFD SET[3ACK 5T9GLT SETAACK HLAR YARD SET9ACk PLAN OIECK NUh1�ER PIAN CHECK FEE <br /> FEE RECtIPTNO <br /> US[ZONE �pT ANEA VACANT f1T[ <br /> '. '.YES '.;NO FEES VAIUATION FEE <br /> TYt'E OF CANST. OCCUPANGY GROUP NO.OF DWELUNG UNITS <br /> �UILOING E <br /> SIZf.OF BLDG NO OP SiORIES Abi%.OCC.LOAD <br /> PLUM�ING <br /> L FlRE20NE �ASEMENT FlRF SPPINKLEflS � <br /> R�ouiaEo MecHaNicni 14 50 <br /> :'�.YES I'�.NO <br /> APVROVALS BY OATE �T���R <br /> 1. ENVIRONM6NTAL CNEGK LIST PENALTY U�L. <br /> 2 �UIl01NG PLANS SEC 303(a� <br /> J FlRf.MYDBANi T�TA� 1Q 5� <br /> L a FIRE PROTECTION SYST[M PERMIT VALIUqiION <br /> WHEN PROPERI Y VALID�TED pN iH15 SPACE�THI515 VOUR PERMIT <br /> 5 GRADING <br /> 6. DRAINPGE 3 i 5 3 �O I �. J D —L'� <br /> Z ENVIRONM@NTA�IMPACT STATEAtENi � <br /> B. HEALTN DISTRIGT � <br /> APPUCAiION ACC.BV PlANS CNEG1cED BY APPR.POR ISSUANLE�V YO U R R E C E I P� <br /> THf�NK YOU <br /> ADDRCSS FIL[ � �} FEO g� <br /> L J <br />