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rhr !'��rrireert � <br />��� '� �.ONSTRUGT1011� � <br />everett PERMIT PERMITNO. 16�1�� <br />qTY HALL 259�97d5 <br />EveaeTr.v�n�ezo� ❑ COMBINATION � BUILDING � MECHANICAL ❑ PLUMBING <br />ONNEP MAIL AODRE55 CITY ZiP �HONE <br />Ron Soelhaug 73LL Yew F tr 9RZj]3 '+s'+_nzsti <br />PFLMrtEGT OR OESIGNER MPIL AD�PE55 CIiY ZIP PNONE <br />Harrv Martin 73�� Ye� � rt 4�3- � q1p7 <br />GENERnLC�GTOR MAllA00AE55 CITY 21P PMONE LICENSE� <br />MECMANICRL CONTRACTOR MALL AOORESS CITY ZIP PHONE UCENSE � <br />PWM�ING GONTRAGiOR MAiL AD�RE55 GITY 21P PMONE IICENSE � <br />O NEW C}t ADDITION ❑ ALTERATION Q REPAIR O DEMOLITION ❑ FENCE ❑ SIGN O 1Y00D STOVFIFIREPLACE INSERT <br />ALUf.T10N OF WORK <br />S 6 000 <br />iESGRIpE \YORK <br />geDlace roof _ <br />�flOPOSE� USE OF DUILDING <br />SFR <br />EGAL OESGHIPTION OF PROPERiY �SM01Y BELOIY ON <br />i�t �_e�oCK �_oF ,.Sy.� van <br />PLUMBING <br />SIDE <br />V-K <br />e c.v �i' <br />TYPE OF FI%TURE OR ITEM <br />WATER CLOSET �TOILEn <br />BATMTUB <br />LAVATORY �WASH 6ASIN� <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISMWASHER <br />LAUNORYTRAY <br />CLOTHESINASHER <br />WATER HEATER <br />URINAL <br />DflINKING FOUNTAIN <br />FLOOR DflAIN <br />VACUUM BREAKERS <br />ROOF DR+!NS — RAINLEADERS <br />SINK �SERVICE — 6AR, ETQ) <br />SUB TO' <br />PERMIT <br />TO7AL1 <br />NA <br />R-3 <br />1 HEFlEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS T"PE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIF�ED HEREIN OR NOT. THE GRANTING OF A <br />PERMITDOESNCi PRESUMETOGIVEAUTHORITYTOVIOLATE <br />OR CANCEL TH PRnVISIONS OF ANY OTHER STPTE OR <br />LOCAL LAW GULAT G CONSTRUCTION OR THE <br />PERFOR N OF C STRUCTION. <br />SIGNATURE C TRACiO R AUTHORIZEO D iE <br />X � . / �%' �%� _ c ` c- <br />FEE N0. TYPE OF EOUIPMENT <br />AIR COND. UNITS - H.P. EA. <br />REFRIGERATION UNITS - H.P. EA. <br />BOILER:i - H.P. EA. <br />GAS FIRED A.Q UNITS - TONNAGE EA. <br />FORCE� AIR SYSiEMS - B.T.U. M EA. <br />WALL HEATERS - O.T.U. M <br />UNIT HEATEPS - B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRVERS <br />VENTILATION FAN <br />RANGEMOOD <br />AIR HANDLING UNIT - C.F.M. <br />SiOVE - YlOOD <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />MEAT PUMP <br />�S <br />REAR VARD S <br />� A— <br />VACANT SITE <br />YES g NO <br />1 <br />NA 2 -' <br />FIRE ZONE BASEMENT FIRE SPP <br />REOUIRE <br />YES <br />APPflOVALS BY <br />1. LNVIFGNtdENTAL CHECK LIST <br />2. BUILDING PLANS <br />J. FIRE MYDRANT <br />4. FIRE PFOTECTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7.ENVIRONMENTALIMPACTSTATEMENT <br />B. HEALTH OISTHICT <br />ACC.BY <br />SG I JEF <br />� <br />SUBTO7AL <br />PENMIT <br />TO7ALFEE <br />16619 FEE 36.73 <br />FEES VALUATION <br />5 <br />S <br />S <br />ree <br />BO4I�IPT NO. <br />FEE <br />ELLING UNITS Building Nde Surch rge 1. <br />LOAD BU'LDI!JG 5'��p, Ql f� �_ <br />8b �S= <br />PLUMBING / <br />KLERS MECHANICAL ���� <br />�O <br />OATE OTHER B SRCN S.SO _ <br />� <br />_ PENALTY SEC. 303 (a) <br />TOTAL SB. <br />PERMIT VALIOATION <br />WMEN PROPERLV VALIDATED (ItJ THIS SPACE) TMIS IS YOUR PERMIi <br />APPR.FORISSUAI.�E BV <br />LC <br />ADDRLSS 19LE <br />' �' <br />c i <br />� ; <br />