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-� - <br /> , . " ,A , ; �';ONSTRUCTIO �" <br /> ,:T��� <br /> everett PERMIT PEFtMIT NO. 1�1i1 <br /> CITV HALL 259�8745 � <br /> EVERETT,NJA9B201 ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> ow"ER BIJRLInGTOV NORTHBRN 3U3"SDO,��L�CSON SP.ATTLE P1�AY Z�P PMaNE <br /> FRCHITEGT OH DESIGNEF <br /> MAIL ADDRE55 CITV ZIP PHONE <br /> GENERAL CqNTmAeCTOR MAIL A��RESS CITY 21P PHONE UCENSE N <br /> Jil <br /> MECHANICAL CONTRRCTOR tAAIL A00t1E55 CITY ZIP PHONE LIGENSE M <br /> PWMBING CONTRACTOR MAIL ADDRE55 UTV 21P oHONE LICENSE M <br /> CLA55 OF WORN <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION �REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD S70VFJFIREPLACE INSERT <br /> VALUATION OF K'ORK <br /> 5 ZS�O.00 <br /> DESCRIBE WOflK <br /> Construct new roof destroyed by fire _ <br /> PROPOSEO USE OF BUILDING <br /> Yard office for train crei��s I HEREBY CEFTIFY THAT I HAVE READ AND EXAMINED THI <br /> APPL�CATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGFLDESGFIPTIONOFPBOPERTYISHOWBEIOWORARACHFOURCOPI[5� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> ioT 9BLOCK_OF �OVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VI0�,4TE <br /> 16-29-5 OR CANCEL TH[ PROVISIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERF PdANCE OF C NS TION. <br /> J00 AOOFESS 3 �Z �� _ �JC 7-h f f- $13NAT OF CONTR TOR A 0 0 AGENT �ATE <br /> 15t1i and 19alnut X "� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATERCLOSET�701LE� AIR COND. UNITS— H.P. EA. <br /> BA7HTUB REFRIGEFATION UNITS — H.P.EA. <br /> LAVATORY�WASH BASIN) BOILERS— H.P. EA. <br /> SHOWER GAS FIRED A.C.UNITS —TONNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED 41R SYSTEMS— B.T.U. M EA <br /> OISHWASHER WALL HEATERS— B.T.U. M <br /> LAUNDRY TRAY UNIT HEA7ER5— B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WATER HEATER CLOTHES DRYERS <br /> � URINAL VEN7ILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UIJIT— C.F.M. <br /> VACUUM OREAKERS STOVE—WOOD <br /> ROJF ORAINS— RAINLEADERS METAL FIREPLACE&CHIMNEY <br /> SINK(SEfiVICE— BAR,ETC.) FIREPLACE INSERT <br /> HEAT PUMP <br /> SUBTOTAL S SUB 707AL S <br /> PERMIT S P�HMIT 5 <br /> TOTAL FEE 5 TO7AL FEE S <br /> SIDE YARD SETBACK STREE7 SETBACK REAR YARD SETBACK PLAN CHECK f;UMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AFEA VACANT SITE FEES VALUATION FEE <br /> :�.YES .:NO <br /> TYPE OF CONS7. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> BUILDING �5��.�0 3$ SQ <br /> SIZL OP BLDG. NO.OF STORIES MAX.OCQ LOAD <br /> PLUMBING <br /> FIREZONE BASEMEN7 PIRE SPRINKLERS �ECHANICAL <br /> REOUIRED <br /> . �.YES �-:NO <br /> APPpOVALS BY DATE OTHER <br /> 1. ENVIRONMENTAL CHECK LIST PENALTY U.B.C. <br /> SEC.903(a� <br /> 2.BUILUINGPLANS TOTAL 3S SO <br /> 3.FIRE HYDRANT <br /> 4.FIRE PROTECTION SVSTEM PERMIT VALIDpTION <br /> WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS IS YOUR PERMIT r-.� <br /> 5.GRA�ING r,..+ <br /> 6.�RAINAGE ,�.--4 <br /> 7.ENVIRONMENTALIMPACiSTATEMENT (,[) <br /> 8.HEALTM DISTRICT �"I <br /> APPUCATION ACC. BY PLANS CHECKED BY APPR. FOF ISSUANCE BY <br /> SLg 1C <br /> ADDRESS f-ILE <br />