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� rhe Ecc+yn�rn <br />� CITY OF I <br /> CONSTRl1CTI0N ���eretfi ! <br />� everett PERMlT ; <br />� u�r rmu zsscees <br /> (VEP[ti,MRSMiN4tOM I <br /> 96]O1 � <br /> °"` °` `°""°°"' gUILDING MECHANICAL PLUMBING ' <br /> otvuovu[xt <br /> OWNER MAILADDflE55 ZIP PIiONE <br /> � a :* PNIriP:,pS i,;f�s-�7 <br /> AFCHITECT OF DESIGNEfl MAIL AODRESS PHONE LICENSE NO. <br /> GENEFAL CONTRACTOP MAIL ADDflE55 PMONE LICENSE NO. <br /> R E T COST&TF.'CCSIO:i I�iC. i <br /> MECHANICALCONTfiACTOR MAILADOftE55 PNONE LICENSENO. � <br /> PLUMBINGCONTRF OR � MAILADDRE55 PIIONE LICENSEN�. � <br /> W <br /> m • <br /> PEFMIT CLASSOFWORK � I <br /> Z <br /> �DUILOING �VWMBING ❑MECMANICAL Y �- I <br /> ❑NEW OAOOITION pALTEflAT10N ❑PEPAIF � <br /> VALUATIONOF WORK � <br /> g lI��E'�IQ.QO ❑OEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL a <br /> DESCNIBE WOFK <br /> canetruct chsea !or clenatflr 29�.Z <br /> PROPOSEO USE � <br /> MECHANICAL ' <br /> rvaEorFUE� poi� pN.+r. p�a�. �E�Ec. <br /> LEGAL OESCRIPTION OF PqOPERTV ISHOW BELOW OR ATTACH GAS <br /> FOUqf,pr�g� 335 IN4IAtL D�V. T'I NO. TVPE OF EOUIPMENT FEE <br /> LOT 1�; dBLOCK—OF qlfl COND. UNITS- H.P. EA. $ I <br /> A6FRIGEFATION UNITS-F;.P. EA. <br /> �OILERS-H.P. [A � <br /> GAS FIREOl�.C. UNITS-TONNAGE EA. <br /> FOfiCED AIF Sv5TEM5-O.T.U. M EA. I <br /> JOB qC�D�E55�1rCaa�Pap _ WALL HEATERS-B.T.U. M <br /> l� �� UNIT HEATERS-�0.?.U. M I <br /> EVAPOFATIVECOOI.ERS <br /> PLUMBING CLOTNES ORVERS � <br /> VENTIIATION FAN <br /> RANGEHOOD I <br /> NO. TVPE OF FI%TURE OR ITEM FEE nin r+nn�b�iN�UNii- C.F.M. <br /> WATERCLOSETITOILETI g �NCINEIiATOR � <br /> �ATHTUB <br /> LAVATOFV IlYASM BASIN) I <br /> --�� SHOWGR . <br /> I� KIT�HEN SINY. P� DISP. SUB TOTAL S � <br /> DISHWASNEfi PERMIT $ <br /> _ LAUNDRY TiiAV 70Tq� FEE � � <br /> _ fl t�THFS WASNEfl THIS PEPMIT DECOMES NULL AND VOIO IF WOflK OF CONSTRUC� <br /> WATEfi IIEATER TION AUTHORI7ED IS NOT COMMENCEO WITHIN 120 DAVS, OP IF <br /> VRINAL CONSTNUCTION OR WORK IS SUSPENDED JF AOANDONED FOR A <br /> DRINKING FOUNTAIN 7ER100 OF 1�0 DAVS AT ANV TIME AFTEp WORK ISCOMMENCED. <br /> F�OOR-SINK OR DRAIN I HEFEBY CERTIFV THAT I HAVE READ AN� EXAMINED THIS AP- <br /> VACVUM BREAKERS PLICATION AN� KNOW TME SAME TO 9E TPUE AIJD CORRECT. ALL <br /> PODF Of1AIN5-RAINLEADEflS PROVISIONS OF LAWS AND OROINANC[5 GOVERNING 7HI5 TVPE <br /> . ____ _ . OF WOqK WILL �E COMPLIED WITH WHETH[R SP[CIFIED HERF.IN <br /> SINY, ISERVICE-O:.R, E7C.) �i Oli NOT, THE GRANTING UF A PEftM1T DOES NOT PPESUME TO <br /> GIV6' AUTHORITY TO VIO�.ATE OR CANCEL THE AflOVI510fJ: OF <br /> ANY OTHEP STATE OR LOCAL LNW fiEGULAiING CONSTRUCTIOtJ <br /> OR THE PEFFORMANCE OF CONSTRUCTIpN. <br /> SUB TOTAL � <br /> PEPMIT S <br /> TOTALFEE _$ 7/20/'�7 <br /> X <br /> SIGNATUIiEOFCONTRt,CTORORAVTII.AGENT DATE <br /> SIDE VARDSGTOACK STREET SET�ACK REAR VAilOSEi�AC PLAN CHEGr NUM1I�ER PI_0.H f.HECK FEE <br /> USEZONE IOTAflEA VACANTSITE 7•J�1'4AJ FEE ����� R�C.f�IfjLJO. <br /> J4LJ <br /> ❑ves ❑No FEES VALUATION FEE <br /> TVPL OP CONST. OCCUPANCY GFOVP NO.OF DWEIIING <br /> UNITS I � I <br /> SIZE OF 6LOG. NO.OF STORIES MA%.00C. LOAO BUIL�ING $ � � � " �� <br /> I <br /> PIUMBING � <br /> FIREZONE BASEMENT FIFESPFINK�EiiS I <br /> R ❑YESED ❑ND MECHANICAL I � <br /> SPECIAL CONDITIONS: OTHER � <br /> I <br /> PENELTV SEC.3031a) I <br /> — TOTAL ��� �. � �� <br /> I <br /> PERMIT VALIDATION <br /> . WHENPROPERLYVALIDATEOIINTH�SSPACEITHISISYOURPEqA11�' <br /> MPtILAtIONALCEPTED9Y: PLAHSCHECLCE:�. AiN110VWf0^�^F+CEBV: � . ' <br /> X �, <br /> � <br /> � <br /> I <br /> � <br /> � <br />