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�� AP�LICATION FOR � � <br />OmEvi-'ercen C NSTRUCTION, e <br />a�'i' or <br />everett PERMIT <br />DFPT. UF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-0715 <br />EVERETT,'.VA%201 ��OMSINATION ❑ BUILDING ❑MECHANIGAL ❑PLUMBING PERMIT NQ. <br />OWNER MAIIA�DRl55 CITY ZIP PHOH[ <br />�uye�ue'�R�Aa�oPec��v �2s �u�l!e✓z ��e�e1=1_ 9s2oi zsZ-zge� <br />� LP PMO f <br />l�']� <br />MUMBIHG COHTN�CIOR MMl AOORl55 CITY ZIP PNON[ UCENSf I <br />� <br />CUSSOf WORI( <br />❑NEW ❑AODITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />VAIUATION O�,F �WO,N�K7 <br />s sUv" � — <br />DESC0.1 WORk <br />� �� ,J �� .Ve Kl P s ��..u,r[.s�// sG�iwv Lo1_. , Fs'� �'l.¢.�un�cP <br />PROPOSFDUSF Ot 9UIlUMG � I HLKLBY CERTIFY THAT I HAVE READ AND EXAMWED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />lfG�l D6CRIPlIONOf PNOPtNiv151�OWN 11llGY:OR nlinn� fOUR COPIf51 PROVISIONS OF LAWS AND ORDINANCE$ GOVERNING THIS TYPE <br />� � OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />ior 1,5 _eioca / 3 � ov ' ' x V' e`� � OR NOT. THE GRANTING OF A PERMIT DOES MOT PRESUME TO <br />GIVE ,4UTHORITY TO VIOLATE OR CANCEL THE PROVISION$ OF <br />�2eTl i.o / e� S '! I ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />R THE PERFORMANCE OF CONSiRUCTION. <br />I�O S G � L O 5 NATURE OF CONTRACTOR OR AVTNORIZFD AGENT DAiE �G/FD <br />� <br />IOBADDRE55 _ _ �`r�� � G� ��� `1�n� q <br />►LUM�ING <br />NO. <br />WATER CI <br />pATHTUfi <br />UVATOR <br />SNOWER <br />RE OF FIXTURE <br />�TOUET� <br />�SH PASIN� <br />a oisr. <br />UUN�RY TRAK <br />CLOIH[S\4ASHER <br />WA7ER HEATER <br />URINAL <br />D2INKING fOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />k(�F DRAIN$—NAINIFAD <br />SINK6kHViCL—O�N CiCI <br />SIDF YARD SFT <br />20 � <br />ll$l ZONE <br />TVPE Of CONS <br />SIZE OF OLDG <br />FlRk ZONC <br />Si RI : T S[ t llnt r: <br />,� n ' <br />ioi nurn <br />OQUPANCY GROUP <br />NO Of STORIlS <br />f1A5[A1[Nl 111 Uft� <br />APPROVAlS <br />1. [NVIRONMLfJTAL CHLCK ll$i <br />]. OUIIUING PLANS <br />3. FIRE HYDRANT <br />�. :IFF PRO7CCTION $YSiCM <br />5 GRAUINGII%U\'AlION6CIlARINGGRUI1111NG <br />6 DRAINAG[ <br />L ENVIRONMfNUI IM1IPACT SUTkMLNT <br />E. HEALTH OISTRICT <br />♦FV11( A� <br />9-1�79 <br />PUN$ CN[CALD 11Y <br />MECHANICAL <br />FEE N'. TYPE OF EQUIPMENT FEf <br />AIN CONO. UNRS—H P M <br />N[fRIGfRATlOY UNRS—HP. EA <br />IIOIL[R$—IIP [� <br />GAS IIBkD AC. UNITS—iONNAGE EA <br />fONCLD nIR SVAEM1IS—OSL M U � <br />\VALI NfA1IR5—OTU \ M <br />UUI1111AiINS-11TU M11 � <br />I\'�POR�T�VI COOLLRS <br />CIO7HR URYLRS <br />VI NI ILA710N f Au <br />unnc� ��oou <br />'IRIIAM1I7LINGUM1I7— GFM <br />SIOVI <br />All TAl I IRI PI.ACL A Cj11A1NE1' <br />SU6TOTAL s _ <br />S <br />H[AN YARI) 11111ACK PLAN CIUCK <br />�C� � <br />vncnn�tsnt <br />nvt5 Y�+o <br />n�o oi u�vtwn�c units <br />A1A% <br />BY <br />flUIIDING <br />I'1 UMItING <br />NU��1I11N PUN CN[CK IFE <br />��.L RLC[IfTNO. <br />fFES V�WATION FEF <br />f <br />D�T�n11CHANIUI <br />O7 HfR <br />AI'PN IOR ISSUAWC; ii1 <br />� � � <br />PI NAI i1' <br />UOC <br />SIC JOJIa) <br />TOTAI I I <br />PLRMIi VAUDATION <br />R'HLN PNOPf NI1 \'AI IUA71 D �1N 7H15 SPACq THIS 6 YOl'R PEHMIT <br />