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thc Evcr.qrcen <br />��,���� CONSTRUCTIQN <br />everett PERMIT <br />,�,.,,:.,, >,�::A, <br />„����, ,��.,,�,,,,,,� <br />,�:„ <br />°`°, °' �°'"'°�°� BUILDING MECHANICAL PLUMBING <br />tltY[lOVMtNI <br />NLN MAIL AUUHL55 I.IP YRONL <br />�1Gillrr/ c;. ::D'LS:I�r.: I`.�.?! .QVCI'ZJ 3.,7A0 �:�F�a �•r;;�'l i 7:i`>'�iS'�t� <br />icn�corvrnncroa <br />i <br />Ml�IL ApURE;S <br />❑ DUILOING ❑ PLUM�ING � M[CHnNICnL <br />❑N[W �l�DOITIUN ❑ALT[RATION ❑H6'M{t <br />✓ALUATION OP WOf1K � <br />s .�,� j�l(�� JO — ❑p[MOLI;11- ❑F[NCE ❑SIGN ❑SWIMMING YOOL <br />]ESCRIOG WORK <br />.ngla car .�ar.�7�, 15Q aq. £t. r�tion 3ocl; �7ci >>Iack top r!riv��vay <br />�noroseo usE MECHANICAL <br />LEGAL OESCRIVTION OF P(iOPERTV ISIIOW 13ELOW OR A�" .'.CH <br />FOtI OPIE�1 <br />10T�� J OLOCK—OF— DQYISr�y nCr$S t <br />�ooAo��,� L��Qrly Lana <br />PLUMBING <br />TU[I <br />TORV INASH �ASIN) <br />�EFi <br />IiN SINK P. OISP. <br />VASHER <br />or�r rnnr <br />HES WASHER <br />R HEMER <br />�l — <br />UNG FOUNTAIN <br />N-SINK OH OfiAIN <br />UAA I3R[AKEFS � <br />OqA1N5-HAWLEApERS <br />�SEFVICE-�AP, ETC.) <br />SUOTOTAL <br />PERiAIT <br />TOTALFEE <br />::P[CIl�L CONDITIONS <br />❑vEs ❑no <br />—� �-cns — <br />TVPE OF EOUIPMENT _ <br />AIR COND. UNITS- H.P. EA. <br />REFRIGERATION UNITS�-H.P. EA. <br />AOILERS-N.P. EA. <br />GAS FIFE� A.C. UNITS- TONNAGE EF <br />FORCED Alfi SVSTEMS-f3.T.U. M EA. <br />WALL MGMERS-�.T.U. M <br />UNIT HEATERS-F1.T.U. M <br />EV/�POPATIVECOOLERS <br />CLOTHLS DRVERS <br />VENTILATION FAN <br />RANGEHO00 <br />AIR HANOLING UNIT- GF.M. <br />INCWERATOR <br />S <br />everett <br />9iG'77 <br />� <br />W <br />m <br />� <br />� <br />2 <br />H <br />� <br />W <br />6. <br />2769 <br />I SUp TOTAL S _ � <br />PE(iMIT $ �— <br />- I <br />TOTi�L f-EE 5 � <br />THIS ?ERVi 6cCOMES NULL AND VOID IF WOf1K OR CONSTFUC <br />TION AU' ��: ti12@D IS NOT COMMENCED 1YITHIN 12Q DAVS Ofl IF <br />CONSTfiVCTION OR WOf1K 'S SUSP[NDEO (.Fi AUANDONED FOR A <br />PERIOO OF 12U OnVS AT ANV TIM[ APTCR WORK IS COMMENCEO. <br />I MEREl3V l'EATIFY THAT I HAVE qEAn AND E%l1MINGO THIS AY- <br />�'LICMION AM1O KNOW THF SAh1[ TO �E iRUE �ND CORliECT. ALL <br />PRO'JISIONS O� LAN.'S /1N� OFDIIJANCES GOVERNING TNIS TVPE <br />OP WORK WII.L �E COMVLIED V/IThI WHETHER SPECIFIED HEFiEIN <br />OR NOT, THE Gf1ANTING OP A P@IiMIT pOEII NDL PfiE:iUMB TO <br />GN[ I�UTHUfi1TY TO VIOLATE Ofi CANC@L TME PROVISIONS OF <br />AN'/ OTHER STnTE OR LOCAI LAtV R[GULATING CONSTf1UCTION <br />Oq TIIE PERFO{iMANCE O� CONSTRUCTION. <br />x <br />51C3hAlURE OF CUNTi <br />'LAh CH[CK NUMflER <br />:tiOI1Q <br />FEES <br />b/23/77 <br />PLAN CIIECK PEE <br />FEE �F.CEIPT NO. <br />VALUATION FEE <br />.00QLOAD FlUILUING 5 �������v �v j��� <br />PLUMOING �I <br />SPHINKLE(!5 —y— <br />IIINED � <br />Vl5 [��JO M[CHANICAL I <br />— I — <br />OTHER � <br />_ I <br />PENELTV SEC.8031a1 -�� <br />_.____.-- _ -_ .�i �G� <br />TO7AL 1 <br />PERMIT VALIDATION <br />- WHf.N I'RUP[f:l.Y VALIUATED (�N T1115 ;P�C[I THI515 Vpl1R P[RM1IIT <br />n:rnav[oion�,ssunr.� <br />