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CITY HALL 255�87t5 <br /> EVERErr.v�n ee'�u� ❑ COMBINATION �BUILDING ❑ MECHANICAL PLUM9�NG <br /> IARIL NDL�9E55 PIIONE <br /> o�:�nee � Z�568-2755 <br /> Gayle L. Gilbertson <br /> „R'HrtECi OF DESIGIJER <br /> MAILAODR:55 CGY ZIC CHOY' �� <br /> GENERALCONTRACTOR <br /> IAAILRpDRE55 CITY ZiP PNO�IE LIGENSE� <br /> Bzooks M. Gilbertson 98258 334-2322 <br /> vFC�IAHICAI CLNTRACiOR <br /> MAILFDDRE55 QTY ZIP PIIONE L�CEtlSE� <br /> r W IABiNG CANiRACTOR <br /> MAIlA�D1E55 GITY ZIP P��OYE LICE�SC <br /> C�.A55 OF 1YORK <br /> ❑NEW ❑NDDITICV ❑ALTERAT.�N �REPAIR ❑�EMOLITIO�d ❑FENCE ❑SIGN ❑GAAAGE <br /> VfLUATION OF WORK <br /> 5 3,000.00 <br /> DESCRIBE Y/ORK <br /> repair utility room <br /> vBOPOSED Vo'EOf BWL�MG <br /> sing:_e family resi3enca I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP� <br /> -�-=cti�oes.airnor+eFNaoPe�rvrs�o��vae�ewonnrtnc��FouecoPiesi PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> ��r 7 ._2Le�a� 1S�; pin?hurst Div. "B" TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIV[AUTHORITY TO VIOLATE OR CANCEL THE PP.O� <br /> VISIONS OF ANY OTNE�I STATE OR LOCAL LAW ReGULATING <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> SiGnnl�IkEqcCoritNnQORONA'J�HC�ZEo,� cA:E <br /> :o9nooaess u" ' 3/7/80 <br /> �r, zizo� Maa�so, X � .z. �L'� ���``..�� <br /> PIUMBING MECHANICAL, <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF E�UIPMENT <br /> FEE <br /> . AIR COND.UNITS—HP Ea <br /> WATER CLOSET(IOILET) <br /> REFRIGERATION UNITS—F�.P EA <br /> BATHTU� <br /> LAVATORY(WASH BASIN) BOILERS—H.P.EA. — <br /> GAS FIRED AG.UNITS—TONNAGE EA. <br /> SHO\NEH <br /> FORCED AIR SYSTEtdS—BS.U. M EA. _ <br /> KITCHEN SINK 8 DISP. M <br /> WALL NEAiEPS—B TL. <br /> DISHWASHER <br /> — UNITHE�TEP.S—PTU M <br /> LAUNDFiY TRAY <br /> EVAPOFAiIVE COOLERS <br /> CLOTHES WASHEH CLOTHES URYERS _ <br /> WATER HEATEfl <br /> VENTILATION FAN <br /> URINAL RANGE HOOU <br /> DHIIJKING FOUNTAIN GF.M. <br /> AIR HANDLIf:G UNIT— <br /> FLOOR ORAW — STOVE <br /> VACUUM�FIEAKERS <br /> IdETAL FIREPLACE 8 CFIIMNEY <br /> ROOf DRAINS—RAINLEADERS <br /> SINK�SERVICE—BAR ETC.� <br /> SUBTOTAL : — <br /> SUB TOTAL PERMI7 : <br /> PEflM1T S <br /> - S TOTAL FEE f <br /> TOTAL FEE p�qN CHECK FEE <br /> 5'.Pi= vARD SETBACK STREET SCTf3PCK R[AR YAF7D SETBACK PLAN CHECK NU�10EH <br /> F[E RECEIPT N0. <br /> 7295 12.00 27650 _ <br /> US.:ZONE l0T AREA VACnNi SITE FEES VALUATION FEE _ <br /> i..iYES I��O <br /> 1 YPL OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS — <br /> V-N R-3 1 BUILDING 5 24 00 <br /> S�ZE OF�LDG. NO.OF STORIES MnX.OCC.LOAD <br /> 8�%zl� 1 PLUMBING <br /> f°IREZONE BASEMENT FIRESPRINKLERS MECHANICNL <br /> 3 REOUIRED <br /> ❑vES ❑NO <br /> APPHOVALS <br /> BY DA7E OTHER <br /> t CINIRONMENTALCNECNLIST PENALTV U.BC. <br /> SEC.303(a) <br /> .' UL�ILDING PlANS TOTAL Z4 OO <br /> 9 FIRE HYDRANT <br /> PERMIT VALIDATION <br /> : FIRE PROTECTION SYSTEM WHEN PROP'cRLV VPLIDATED(IN THIS SPACE)THIS IS YOUR PERIAIT <br /> S GRADING 9 2 5 G � O ��•0 0 �_� � <br /> fi ORAINAGE (v <br /> � F.NVIFONMENTAL IMPACT STATEMENT � <br /> : HEALTHDISTRiCT �✓'�1 �' ��P 1\ECE.�PT� <br /> APPLICATION ACC.BY PLANS CHECKED BY APPR.FOR ISSUANCE BY ��.� �� <br /> V.C. .. <br /> — � i:�,i <br /> -i� : - � . , <br />