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� �' '; — CONSTRUCTI01� E, . , � <br /> everett <br /> PERMIT vcrctt <br /> r::��� ��.tL� 2598�a5 <br /> , �_�<r�T, �vn uazoi COMBINATION • BUILDING • MECHANICAL • PLUMBING <br /> U�YNER MAIL nDORE55 <br /> LP PHONE <br /> S• J. 22onteiti� 3505 Broad�.:iv � <br /> nRCHiiECT OR DESIGNER m <br /> MAIL ADDHE55 - <br /> �'HONE L:CEIJSL tip. 3 <br /> GLNERAf.CONTRACTOF MAILADORESS � <br /> PHONE LICENSE NO. <br /> Z <br /> MECHANICALCONTRACTOR MAILADDqESS C <br /> PHONE LICENSE NO. � <br /> 17�tural Gas E uipment w � <br /> PLUM11fiINGCONTRACTOR MAI�ADDRESS �� m <br /> PMONE UCENSE NO. ' � <br /> PEHMIT CLA55OF WONK �� <br /> ❑COMBINATION � - <br /> ❑6UILOING �PLUMBING �MECNANICAL � <br /> ❑NEW ❑ADOITIOPJ []q�7ERATION ❑REPAIR <br /> VALUATION OF WORK <br /> 5 ❑OEMOLISH ❑iENCE ❑SIGN ❑$WIMMING POOL I <br /> DESCRIUE WORK <br /> S7a11 F��rnace <br /> Pr�ovosEo use � <br /> MECHAhICAL <br /> LEGALDESCRIPTION OF VfipPERTY ISHOW(3ELJW Oq qiTACH T��'E Of- fN[PGV � <br /> FOURCOPIE51 ❑+AS ❑ELEC. <br /> LOT BLOCK_oF_ _ NO. TVpEOFEQUIPMENT FEE <br /> AIH COND. UNITS_H.p, Eq, S � <br /> REFRIG[fi/�TION UNIT; H,P. [A. �--- � <br /> _ POILERS- H.P. [n.----- . � .. <br /> FOqCEO !11(i SVSTEMS-�O.T.U. MEA. <br /> JOB ADDRESS — - I.- � <br /> .�iSOS UTO:t(iF/,7y _ �I f_��ACE & WqLL NEATERS - B.T.U. II � <br /> ,UMi H[ATEfiS- f3.T,U. � <br /> PLUMBING . �yvnronnTivecoo�eas <br /> _ �CLOTHEiDRYERS � <br /> VCNTILATION fAN <br /> NO. TVPE OF FIXTUHE OR I7EM ---- '+�,N`��i���� � <br /> FEE AIHH/�hDLINGUNIT- 0.F.M. <br /> BATN 1U95 S - _ ___.____ <br /> CLOTHES WASHEF � . ._. ._ _.___'___ .— � <br /> UISH WASHERS � �'�'ATEii HEATER -- <br /> DNINKING FpUNTA1N5 FnC. RUILTr�IREPLACE 6 CHIMNEv � <br /> � _. _ <br /> FLDOR OIiAINS � GAS. SVSiEM: NO OP OUTLETS -- . <br /> KITCHLN SINKS & �ISP. i � SUR TOTAL § [ � --- <br /> f3AR $WKS -- - '------ 1 I�0 <br /> � PEPMIT 5 <br /> ROOF DHAWS - RAIN LEADERS � � 10TnL PEE S <br /> SHOWEfl IIATHS - - --- I � <br /> SERVICE SINKS ������ �'�-�aMIT UECOMES NULL ANO VOIO IF WOqK OR CONSTHUC <br /> TION 4UTHORIZEO IS NOT COMMENCED WITHIN 110 DAVS, OH II <br /> SUMPS - SLWf1GE PUMP CON;iRUCtION oR WonK IS SUSPhN(]GD OR nOnNDONED FOR n <br /> UflWf�LS —� PERIOD OF 12P DAYS AT ANY TIME AfTER WORK ISCOMMENCLD. <br /> WATEH CLOSETS � I HEHEt1Y CERTIlY TIIM I HAVE R[AU AND EXt1MINED T1115 AP <br /> WATEH HEATERS - ELECTNIC � �'�-�CnTION AND KNOW THF SAM[ TO 13L TRUE AND CO(iqFCT. ALL <br /> WASH BASINS PfiOVI;lONS OP �_/�W; l�ND ORDINANC[5 fiOV@HNING THIS TVPf <br /> LAUNDflV THAYS � Of WOHK WILL UE COMVLILD WITII WHETHER ;:PECIFIEfJ H@RPIN <br /> DR NOi, TryE Gq/�NIING OF A PEIiMIT pOEi NOT PqESUME lc) <br /> GIVG AUTHpq�TY TO VIOLATE OR CANCEL THG PROVISION; Of�- <br /> � /�NY OIHEIi STATE OR LOCAL LAW (iEGULATING CONSTRVCTIOtJ <br /> DR TH@ PEIiFORMANGE OF CON57RVCTION. <br /> -__ � <br /> SUB TOTAL <br /> PEHMIT S <br /> TOTAL FEE x � � <br /> W�T[H SERVICE SIZE - -+�--`{''���'L���=�_+-_J IZ,�O�: 77 <br /> BLnG. SUPPLV SIZE SIGNATURLpr�t,pryifiM1CTOflORAUT11.qG[NT pA7E � <br /> :�If)C V/�RD SETfiACK STR[E7 S[TAACK REAR VARpSETfiACN PLAN CH[CK NUMBEP <br /> PLAN CIIECK FEE <br /> — �-E� RLCEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> ❑�ES ❑NO . ._ _ _- __.. . __ ___ <br /> TVPE OF CONST. OCCUPANCV GAOUP NO.Of OWELLING FEES VALUATION FEE <br /> _."-___ _ _- <br /> UNITS -T— <br /> I <br /> -GiZE OF BLOG. NO.OF STORIES MAX.00G LOAfJ dVILOING --� <br /> S � <br /> I <br /> � ii�E Z�N� BASEMENT �IUM�ING -�- <br /> fIRESPqINKL[Ii5 <br /> REOUIRED ._L <br /> ❑YES ❑No MECHANICAL 7����� <br /> ;;�CCIAL CONUITIONS: � J-- <br /> - �---- OTI/ER 1 <br /> I <br /> PENALTY SL�C.30�la1 � <br /> � ' _ ' _1__-- <br /> TOTAL i <br /> _ - I(ln <br /> PERMIT VALIDATION <br /> WHGNPqUP[qLVVALIOATLUIIfJ7111551'/�C � 1 : I!' ' RPEIih <br /> � <br /> ------ �O.UR REDEIPt <br /> ,���,n,�,�,�.,�_����,�,,,� �����,:,,��K����,. ����o���>,�,,,,:���.�,,:� ,,. ' T�`ihNK YO�: , <br /> . .� <br /> n � . � <br /> � � . : � � �� , �' <br /> _�, : _ _ _ .. <br />