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, <br /> ; thr fcrsqrren � � <br /> =�=��F CONSTRUCTION everett <br /> �verett PERMIT <br /> I ❑LV Hill 159BF.E5 ' <br /> fvFPEti,G4.NiNL10Y <br /> OS]1 <br /> "" °`�°""°�"• BUILDING MECHANICAL PLUMBING <br /> nlv[I(1vrqH; ' <br /> OWNEH MAILADDRE55 ZIP PHONE <br /> cL lu+ 1�.• cW. ��ia� � I <br /> a.NCHITEGTOFDESIGNER MAILADDRESS PHONE LICENSENO. �i�� '. <br /> GENEFALCONTRACTOR MAILADORESS PNONE 11C SENO. I <br /> _ .,'�' � .°717PJ I�l'.17�R � <br /> MECHANICALCONTHACTOR MAILADDPESS PHONE LICENSENO. � <br /> PLUMBIN6CONTHACTOR MAILADDflE55 PMONE ULENSENO. � <br /> � I <br /> m <br /> PEHMII' CLA55 OF WOHK � I <br /> Z <br /> �AUILOING �FLUMBING ❑MECHANICAL F I <br /> ❑NEW ❑ADDITION ❑ALTERATION �REPAIR � <br /> VALUATIDN OP WORK � � <br /> s �� ❑DEMOLISN ❑iENCE ❑SIGN ❑SWIMM�NG POOL � <br /> DESCRIBC WORK <br /> ..,,-�•,•tZ'-,-? Z 16 6 <br /> PROPOSED USE MECHANICAL <br /> LEGAL DESGfiIPTION OF f'POPERTY ISHOW 6ELOW OR ATTqCH TYPE OF FU[L � ����� ❑GAS ���PG �ELEC. <br /> FOUP COPIE51 <br /> �or BLOCK_oF _ND. TYPEOFEQUIPMhNT FEE <br /> Alfl COND. UNITS-H.P. EA. S I <br /> REFR�GEftATION UNITS-H.P. EA. <br /> BOILERS -H.P. EA. � <br /> GAS FIRED AQ UNITS-TONNAGE EA. <br /> FOPCEO AIF SVSTEMS-B.T.U. M EA. I <br /> JO�ADOPE55 y� p��r WALL IiEATERS-U.T.U. M <br /> ,�,y�T C'�yby� UNIT NEATERS-B.T.U. M I <br /> EVAPOtiA1 WE COOLEPS <br /> PLUMBING c�oTNesoAVEas i <br /> VENTILATIONFAN <br /> RANGEHOOD I <br /> NO. iVPE OF FIX7UHE OR ITEM FEE A�p ��ANOLING UNIT- C.F.M. <br /> WATER CLOSETITOI�ETI f INCINERATOR 1 <br /> B1�T11T V 8 <br /> LAVATORV(WASHBFS�N) I <br /> SHOW[R <br /> KITCHEN SINK & OISP. SUB TOTAL 5 � <br /> OISI/WASNER PENMIT 5 <br /> LAUN�RV ?flAV TOTAL FEE 5 I <br /> CLOTH[S WASHER TNIS PEPMIT DECOMES NULL nNO VOIO 'F WORK OR CONSTRUG <br /> Wn1ER NEATEF TION AUTHOR2E0 IS NOT COMMENCED WITMIN 120 OAVS, OR IF <br /> UFIIJAL CONSTNUCTION OR WORK IS SUSPENDED Ofl A�ANDONE� FOR A <br /> DRINY.WG FOUNTAIN �EFIOD OF 720 DAVS AT ANV TIME AFTEF WOfiK ISi:OMMENCED. <br /> FLOON-9NK ON ORAIN I HEREI3V CEfiTIFV THAT I HAVE AEAO ANO EXAMIN�D TNIS AP� <br /> VACVVM OREAKERS PLICATION /�NO KNOW THE SAME TD OE TRUE AND CORP[CT. ALL <br /> ROOF DFqINO-PAINLEADER$ PAOVISIONS Of LAWS AND OfiDINANCES GOVERR"NG THIS TVPE <br /> OF WORK WILI BE COMPL�ED WITH WHETHER SPECIFIEO HEFFIN <br /> SINK ISERVICE--AAR, ETC.) UP NOT, THE GRANTING OF A PERMIT DOES NO'f PREGUME TO <br /> GIVE AUTHORITV TO VIOLATE OF CAt2CBL TNE PROVISIONS OF <br /> ANY OIHER STHTE OR LOCAL I.AW RELULATING COfJSTRUGTION <br /> Ofi TNE P[FFORMANCE OF CON5T1iUCTION. <br /> SU� TOTAL <br /> PERMIT 5 <br /> TOTAIFEE $ <br /> x ►.�Y � 'JltTS i�9f 7E' <br /> SIGIJATUftEOFCOIJTRACTORORIaUTH.AGENT DATE <br /> SI�EVMOSETI3ACK STqEETSET6ACK REAAVARDSETBPCKPLFNCl/[CKNUMf3ER PLANCHECY. FEE <br /> FEE RECEIPT tJO. <br /> USE ZONE �OT AFEA VACANT SITE <br /> ❑vEs ❑No FEES VALUATION FEE <br /> TVPG OF CONST. OCCUPANC�'GROVP NO.OF OWELUNG <br /> UNITS I <br /> SIZE OF BLDG. NO.OF STORIES MAX.OCC. LOAO BUIL�ING 5 �� 5 � <br /> PLUMBING � <br /> FIRE ONE BASEM NT PIqESPRINKLERS <br /> RC�UIRED <br /> ❑VES ❑NO MECHANICAL � <br /> SPEGIAL CONDITIONS: OTHER � <br /> PENH.TY SEC.J031n1 I <br /> TOTAL f� (� <br /> PERMIT VALIUATION <br /> WI/[N PROPERLY VALIDATED(IN THIS SPACEI THIS IS YOVP PLflM1T <br /> I /CVLICqT10NFCCEPTE06Y: pUNSCHECKLOpY�. /�CPqpVfUi0N1'.':UN:CLOY. <br /> I � <br /> 6 � <br /> I <br />� <br />