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I eV� <br />, : CI, NSTRUCTION <br /> k �verett PERMIT <br />, DEPT. OF COMM1".UNITY DEVELOPMENT SERVICES <br /> CITY HALL :59�8745 <br /> eveaeT7. �+�.q9a?oi �COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERf�lIT f�0. <br />� ON'NFH I.tAll ADUN SS ❑IY /.II' PMON[ <br />� �j �Pn+P��.-LL'S �ni�� �� ��otfl l�t� ��..i• s,�... C�wtvil <br /> 1 crtr zir r�roNe , <br /> AFCIIIIFCIORO[SILNFR MA4AUUN[55 SI�M� 'J� <br />� G�udcc, `'�lbN l�f'-P• ll��! Mn�C� L�G2a-rf Z<2-c:c�<n �-Z��-r^'� <br />. C!N[RAICONINAfi00. �lU1LADDN(9 CIIY II' PHUNk IICEN5E1 <br /> F <br />� <br />� MLUTANIUICONIRAClOR AIAIIAU�Rf55 ULY LIP PIIONL IICEN EN <br /> J <br />� <br />( PlUn1i11NGCOtiiRAC10R MAIL AOUH[55 CI1V LIP PIION[ llC[NSF t <br /> CUSS O(\1'ONK � <br />�II �NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOUTION ❑FENCF C151GN ❑GARAGE ❑BUILDING RELOUTIOM <br /> I V�W�TIONOf WONK <br /> I y 1 �C� <br /> DfSCRIpI N'ORK . <br /> F'�L- P.L(1'k�-�sQ D�'6�'at%,a�o <br /> reorouousiovnunomc I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> PLICATION AND KNOW THE $AME TO BE TRUE AND CORRECT ALL � <br /> IEGALDESCXIPiIONOiPXOPLRiY15M0\VNPtION'ORAiLnCN(OUNCOPIE51 PROVISIONSOFLAWSANDOR�INANCESGOVERNINGTHISTYPE : <br /> OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> ioT uiocc_ov OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOIATE OR CANCEL THe PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION � <br /> OR THE PERFORMANCE OF CONSTRUCTION. • <br /> SIGNATUHF OF TRACTOR OR AUTHORIZED AGENT DATE <br /> ION AODNE55 y �� I� �� �� <br /> A � ' <br /> PLUMBING M HANICAL , <br /> MO. TYPE Of FII(TUAt FEE NO. TYPE 04 EQUIPMENT FEE <br /> WATER CLOSEL(TOLIEI) AIR CO�D.UNITS—HP. EA � <br /> BATHTUB REfHICEHATION UNIT$—fIP [A <br /> UVATORY(WASH BASIN� I1011f RS-11 P.U <br /> SHOWER GA$FlHfU�C.UNITS—TONNAGE EA <br /> KITCHEN SINK 8 DISP. FOR('LD AIR SY51 tM5—�.T U. ti�E� ' <br /> WnLLHMTENS—I1T.U. M <br /> DISW�SHER <br /> LAUNDRY TRAV UM1If HEATERS—OS.U. M <br /> CLOTHES N'ASH[R f vAPOHATIVt.COOLERS <br /> WATEk HEATER ClO7HE5 DRYfHS �; <br /> \'I:NTIUTION FAN � <br /> URINAI <br /> DRINKINC FUUNTAIN RANGE HOOD <br /> FIOOR DRAIN AB FUNULING UNIT— C.FM. <br /> VANUM BREAKERS STOVE - <br /> � ROOF DRAINS—RAINLEADER$ METAi FIRErUCE A CHLNNEY <br /> SINK(SERVICE—BAR,ETC.1 <br /> SUST07AL f ' <br /> SUBTOTAL <br /> PFIIMI7 S PERMIT f i <br /> � TOTAL FEF 3 TOTAI FEE s � <br /> PLAN CHECK FEE <br /> SIDE YARD SETBACK STRFET SETdACK REAR YAND SLTI7AIX PUN CHECK N�MBER FEE ftKEIPT NO. <br /> USE ZONE LOT AREA yACANT SRf FEES VAIUAiION FEE <br /> ❑YES ❑NO <br /> . TYPE OF CONST. OCCUPANCY GROUP NO.OF�W[LIING UNI75 <br /> 11UILUING S I�(%lY � 7 (�(/ <br /> SIZE OF BIOQ NO.OF STORIES MA%.UCC. LOA� <br /> PWMI7ING <br /> . FIREZONE BASEMENT �!!�NGO.NS FlNf51'NINKLfNS <br /> NEQUIRED MECIIANICAI. <br /> ❑YI S ❑�n <br /> AP►ROVAlS BY DAiE OiI1fR <br /> 1. FNVIRONMENTALCMECKLIST ` pfNAL7Y ��N�� <br /> SK 1011a) <br /> 2. BU�IOING PLAN$ � <br /> TOTAI <br /> 7. FlRE MYORANT <br /> 4. FIftE PROiKT10N SYSTEA: PFRMIT VAUDAiION � <br /> \M1'IIkN 1'ROPCRLY VPtIC'ATED UN THIS 5�'ACrI IHIS IS YOUR PERMIT <br /> 5.GRADINGIEXCAVATIOd A CLf ANINGIGRUI411 WC <br /> 6. DRAINAGE // uL ����J <br /> f�L �� <br /> L [NVIHONMENTALIMPACTSTAIEMENT � <br /> B. MEALTH DISTRICT <br /> APPLIUTION ACC.flY P 5 CMfC ED NY AI'I'N fOR ISSUA l B� � <br /> C�� �Z � ?� ' <br /> /1��� �/�/� � <br /> ��.�.�g � <br /> I <br />