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a"oro..A C 0 N S T R U C T 7 0 <br />eveTett PERMIT <br />� l PYereD <br />. <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 2S9-6745 <br />'VERETT.WA95201 OCOMBINATION ❑BUIIDING L]MECHANICAL ❑PLUTABING PERMITNO,.. <br />--- ZIr PHICIN // <br />ZIP PHONE <br />IICSNSI 1 <br />PHONE IICSNSII <br />PIRMIING CONTRACTOR MAIL AOORISS CITY ZIP PHONE UCINTE <br />CLASS <br />©wDRK <br />NEW❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION [DEFENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />PRO }IDu f of IL ING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALI <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPI <br />1161. of PnoN or r oNRTr HHow a, OR A r CH f <br />R coNl r <br />OF WORK WILL BE COMPLIED WITH TVHETHER SPECIFIED HEREIN <br />to; BLOCK _oE <br />OR NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TC <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OI <br />_-- <br />ANY OTHER STATE OR I rif IA•L P"""' "" <'1nl •l"`^ <br />OR IHL i'LRf UiEl.I, ..L . I , .. . <br />--"-`--- <br />SICNAIURE Of CONTRACTOR OR AUTHORIZED TCLNT DATE <br />10 DORT <br />MECHANICAL <br />PLUMBING <br />NO. <br />TYPE OF fl%TUR[ <br />fit <br />NO. <br />TYPE Of EQUIPMENT <br />FEE <br />WAllR CLOSE H(JIIf TI <br />�oK <br />(N <br />AIRCONOLINIIS-HPIA <br />BATHTUB <br />PI f RIGERATIONLINOS-HP fA <br />LAVATORY IWASII BASINI <br />C_ <br />BOILERS -TIP EA <br />_ <br />L <br />SHOWER <br />CIDGASrIRIOAC <br />UNITS-TONNAG[[A <br />KITCHEN S INK B DISP <br />A <br />3C.Y- <br />T' <br />IORCID AIR SYSTEMS -BTU MIA <br />WAIL Hf A71RS-B T U M <br />DISWASHIR <br />_n <br />LAUNDRYIRAY <br />UNIT HIATLRS-BTU M <br />CLOTHES WASHER <br />00 <br />EVAPORATIVE COOL[RS <br />WATER HEATER <br />CLOTII[S DRYERS <br />URINAL <br />VIN71LAIION FAN <br />ca <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT- C F M <br />VACUUM BREAKERS <br />_ <br />T10V1 <br />ROOF DRAINS - TEMPLE ADF AS <br />ME IAL FIREPLACE 6 CHIMNFY <br />SINK ISIRVICI-BAR, ETC I <br />SUBTOTAL <br />EJb <br />SUN TOTAL 1 <br />PERMIT <br />FIRMIT I <br />TOTAL fit <br />I1 <br />0 <br />TOTAL it[ 1 <br />SIDE YARD $[ TRACK <br />STREET SETBACK <br />REAR YARD"TRACK <br />PLAN CHECK NUMBE0. <br />PLAN <br />I <br />c9"�T <br />Zot=`f <br />2®P� <br />10 <br />s//y7/ <br />FEE a�z '" <br />REGFpalpt�'Na�r <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />fit$ <br />VALUATION <br />TIE <br />P71 <br />DYTS ONO <br />IYP[ OF CONST <br />OCCUPANCY CROUP <br />NO Of DWELLING UNITS <br />BUILDING <br />'70 490' <br />3e� 3 <br />V - N <br />R3 , M <br />SIZE OF BIOG <br />S• F. <br />NO Of STORIES <br />MAX OCC LOAD <br />S <br />R' - f E8 <br />2 <br />PLUMBINGF. <br />/may <br />FIR[ ZONE <br />BASEMENT <br />BIGROOMS <br />1 <br />FIRE SPRINKLIRS <br />REQUIRED <br />MECHANICAL <br />/ v <br />s <br />-- <br />3 <br />❑YIS <br />APPROVALS <br />BY <br />OAT[ <br />OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U B wua <br />SIC <br />2 BUILDING PLANS <br />TOTAL <br />2 FIR[ HYDRANT <br />1 FIRE PROTECTION SYSTEM <br />PERMIT VAII'JAllON <br />WHEN PROPERLY VALIDATED ION THIS SPACE) THIS IS YOUR PERMIT <br />S GRADINO/EXCAVATION B CLEARINCIGRUBBINC <br />-rV <br />6 DRAINAGE <br />/J•^-�•WIL�' <br />/ <br />7. INVIRONMINIAL IMPACT STATEMENT <br />1 HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />APRA. FOR ISSUANCE BY <br />&=_. & , <br />µwrn` <br />L . c. . <br />A i <br />91.79 <br />