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� thd E�rrymcn I <br /> ; ��TYOF �ONSTRUCTION everet� � <br /> ! evere�t PERMIT <br /> i <br /> CiiY H<LL ]59lH¢5 <br /> LV[�IEIi,1':<S�IFLION <br /> 9EAI <br /> ocP�.°o[vuooxcxr BUILDING MECHANICAL PLUMBING <br /> OWNER MAILAUOFE55 21P PMDNE <br /> J�Z I[�'+1� P-"_'� P_4 A„� ].9� :?.:/1�.�1' 2X'L7r72 L`:+�°�"�f, <br /> ARCHITECTORDESIGNER MAILADDHE55 VMONE LICENSLNO. <br /> GENERA�CONTRACTOR MAIL ADDRESS PMONE LICENSE h0. I <br /> I � �� � <br /> WIECMANICAL CDNTHACTOR MAIL ADDRE55 PHONE LICENSE NO. <br /> PLUM0ING CONTRACTOR MAIL ADORESS PHONE �ICENSE ND. � . <br /> W <br /> m <br /> PE RMIT CLASS OF WOFK � <br /> ¢, z <br /> rJOUILDING ❑PLUM9ING ❑MECHANICAL 1- <br /> ❑NEW ❑AD�ITION ❑ALTERATION �EPAIfi � <br /> VAWATION OF WORK � <br /> S 2~ ❑DEMOLISN ❑IENCE ❑SIGN ❑SWIMMING POOL a <br /> OESCF�9F.WORK ���,� r__l ��� ^ <br /> t"�'1 s <br /> rROPoseo usE MECHANICAL <br /> TYPEOFFUEL �OIL �NAT. �LPG. �ELEC. <br /> L[GAL DESCRIPTION OF PROPER?V ISMOW OELOW OR ATTACM GAS <br /> FOUR COPIE51 <br /> LOT BLOCK—OF NO. TVPE OF EQUIPMENT FEE <br /> AIR COND. UNITS-H.P. EA. S I <br /> liEFPIGEFATION UNITS-Ii.P. EA. <br /> - ❑OILERS-N.P. EA. I <br /> GAS FIPED A.C.UNITS-TONNAGE EA. <br /> fORCED AIR SVSTEMS-O.T.V. M EA. I <br /> JOB ADORESS �/y� /� Y•�{f. WALL MEATERS--B.T.U. M <br /> y�liN �aM'=�at'i - <br /> VNIT/iEATERS-B.T.U. M I <br /> EVAPORATIVECOOLERS <br /> PLUMBING c�ona�s oNveas � <br /> VENTILATION FAN <br /> RANGEHOO� 1 <br /> NO. TVPEOFFI%TUREOr ITEM FEE �+Iq HANDLINGUNIT- C.F.M. <br /> WATER C�OSETITOIIETI S INCINERATOfl I <br /> pAiNTUB <br /> LAVATORYIWASH�ASIN) I <br /> SHOWER <br /> Y.IICHEN SINK & DISP. SUB TOTAL 5 � <br /> OISfiWASHER PEFAOIT S <br /> � LAUNCRVTRAV TpTALFEE 3 � <br /> CLOTH[S WASHEN THIS PERMIT EECOMES NULL ANO VOID IF WORK OH CONSTRUG <br /> VIATER HEATEF TION AUTMOflIZED IS NOT COMMENCED WITHIN 170 DAVS, OR IF <br /> URINAL CONST(iUCTION OR WORK IS SVSPENDED OR ADANDONED FOP A <br /> DRINM.ING FOVNTAIN PERIOD OF 120 DAYS AT ANV TIME AFTEfi WORK IS COMMENCEO. <br /> FLOOF-SIIJK OR ORAIN I HEPEAV CERTIFV TNAT I HAVE fiEAO AND EXf�MWED THIS AP- <br /> VACUUM BREAKERS PLICATION AND KNOW THE SAME TO(3E Tf�UE AND CORRECT. ALL <br /> ROOF ORAINS-FAINLEAOENS PAOVISIONS OP LAWS ANO OFDINANCES GOVEHNING THIS TVPE <br /> OF WORK WILL BE COMPLIE� WITH WHETHEF SPECIFIE� HEREIN <br /> SINK ISEFVICE-OAR, ETC.1 OP NCT, THE GRANTING OF A PERAiIT OOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE Ofi CANCEL THE PROVISIONS OF <br /> ANV OTH[R STATE OR �OCAL LAW REGULATIIJG CONSTRUCTION <br /> ORTHEPERFORMANCEOFCONSTRUCTION. <br /> SUBTOTAL <br /> PERMIT S <br /> TOTAL FEE E x � � � _ _ - `. <br /> �!7"7/7�� <br /> SIGNATUfiED�CONTFACTOPORAUTH.AGENT OATE <br /> SIDEYARDSETOACK STREETSETBACK flEARYARD5ET6ACYPLANCHECKNUMf3ER PLANCNECKFEE <br /> FEE RECEIPT NO. <br /> USEZONE LOTAflEA VAGANTSITE � <br /> I <br /> ❑vE5 ❑No FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCV GROUP UNITS DWELLING � <br /> SIZE OF BLDO. NO.OF STORIES MA%.OCC. LOND BUILDING S {,�'�Wr'W � �I <br /> PLUMBINO � <br /> FlRE20NE BASEMENT FIRESPRINKLERS <br /> RE�UIRED <br /> ❑YES ❑NO MECHANICAL � <br /> ';PECIAL CONDITIONS: OTHER � <br /> I <br /> PENELTV SEC.30JIe) 1 <br /> TOTAL � �NI <br /> PERMIT VALI�ATION <br /> WHEN Vf10PERLV VALIDATED(IN TIiISSPACE)THIS IS VOUF 7EfiMIT <br /> ntml.�CnTIONqLCEVTE08Y: v�qry5[NELKE�BY: API'POVED�Oh�SSUANCEOv. <br /> � C� <br /> 0 <br />