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_ � <br /> ; rF,p Evergrcen � <br /> i ��T�roF CONSTRUCTION �verett <br /> �vere�t PERMIT , <br /> urr Hau �s+eees <br /> fiIFE11.1WAUM1LION <br /> 9EYI <br /> -"' "`°°"°""' BUILDING MECHANICAL PLUMBING <br /> o��«o�F.� <br /> i <br /> OWNER MAIL AD�FESS ZIP PHONE , <br /> ��Z�� ry �� <br /> ARCHITEGTOROESIGNER MAILAOORE55 PNDNE LICENSENO. ���� <br /> GENERAL CONTftACTOR MAIL ADORE55 PHONE LICENSE NO. <br /> +3 . iiwp�l ^ �w <br /> MECHANICAL CONTFACTOH MAII.ADORESS PHONE IICENSE NO. <br /> ' PLUMBIN6 CONTNACTOR MAIL ADDRESS PHONE LICENSE NO. � <br /> W <br /> m <br /> PEHMIT CLASSOF WOiiK � <br /> S Z <br /> �]BUILDING �PLUMBING �MECIIANICAL F- <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑PLPAIR � I <br /> VA�UATION OF WONK � <br /> 5 �DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POO� a <br /> DESCR��L WORK <br /> "�x4.it3� 2 2 2� � <br /> � <br /> anoroseo�s� MECHANICAL ' <br /> TVPEOfFUEL �OIL �Nfal'. �LPG. �ELEC. <br /> LEGAL OESCRIPTION OF PROPERTY ISHOW BELOW OR ATTAGM GAS <br /> FOlip�c�pg P��ES) <br /> �oT"� � BLOCK�O� � �tAT A��'ti NO. TVPEOF E�UIPMENT FEE <br /> AIR COND.UNITS—I/.P. Ep. B 1 <br /> REFRIGERATION UN1T5—M.P. EA, �� <br /> fiOILEPS-N.P. EA, I <br /> GAS FIREO A.C. UNITS-TONNAGE EA. <br /> �ORCED AIR SYSTEMS-B.T.U. M EA. I <br /> JUt3 nDO��RyE55 WA�L NEATERS-9.T.U. M <br /> ��i+y;.��i f'�,� UNIT HEATERS-d.T.V. M 1 <br /> E V APONATI V E COOLE FS <br /> PLUMBWG CLOTHES DRYERS I <br /> VENTILATION FAN <br /> RANGEHOO� 1 <br /> NO. 7YPE OF FIXTUAE OR ITEM PEE ��R HANDLING UNIT- GF.M. <br /> WATER CLOSET(TOILETI s IIJCINEFATOP � <br /> BATIiT V B <br /> LAVNTOPY (WASHBASIN) I <br /> '110WFfi <br /> Y.ITU+F u SINK ft DISP. SUB TOTAL 6 � <br /> --- [i1!:1/1%FSHF.R PEHMIT S <br /> _ LAUhGRY TRAY 70TAl.FEE $ � <br /> CLOTHFS WASNER THIS PERMIT BECOMES NUIL ANO VOID IF WORK OF CONSTFUC <br /> _ WAT[R HEATER TION AUTHORIZED IS NOT COMMENCED WITHIN 120 OFVS, OP If <br /> Vfi1NAL CONSTRUCTIOtJ OR WORK IS SUSPENDED OR ABANDONEO FOP. l. <br /> f:l�INY.ING FOUNTAIN PEFIO� OF 720 DAVS AT ANV TIME AFTER WORK IS COMAIENCEU. <br /> PLOOR-SINK OR ORAIN I HEREBV CERTIFV THAT I HAVE FEAO AND EXAMINE� THIS AP <br /> VACVU^A �REAKERS PLICATION AND KNOW THE SAME TO AE TRUE AN�CORRECT. ALL <br /> fi00F ORAINS-RAINLEAOERB PAOVISIONS OF LAWS qND OROINANCES GOVERNING THIS TVPE <br /> OF WDRK WI�L BE COMPLIED WITH WHEI'HEH SPECIFIED HEREIN <br /> SINK ISERVICE-BAR,ETC.) OF NOT, THE GRANTING Of- A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHOfiITV TO VIOLATE UR CANCEL IHE VROVISIONS UF <br /> ANV OTHER STATE OP LOCAL LnW REGULPTING CON>IAUCTION <br /> OR TIIE PERFORMANCE OP CONST RVCTION. <br /> SUDTOTAL <br /> -- PERMIT S <br /> TOTAL FEE E _ _+ � � <br /> �( '�".�7� <br /> SIGNATUREOFCONTFIACTORORAUTH.nGE1JT DAT[ <br /> SIOEVAflDSETBACK STREETSETBACK REARVARDSET�AC PLANCHECKNU�dgER P�ANCNECKFEE <br /> FEE FECEIVi NO. <br /> '�'EZONE LOTAREA VACANTSITE <br /> I , ❑YES ❑NO FEES VALUATION FEE <br /> TVPE OF CON'T. OLCUPANCY GROUP NO.OF OWELLING <br /> UNITS I <br /> SIZE OF BL06. NO.OF STOfl�ES MAX.OCC. LOAD BUIIbINd 5 ��{ ��� <br /> PLUMBING � <br /> FIRE20NE (3ASEMENT FIRESPRINKLE(iS <br /> RE�UIREO <br /> ❑YES ❑NO MECHANICAL � <br /> SPECIAL GONDITIONS: _ OTHEfl � <br /> PENELTV $EC.90b1n1 I <br /> TOTAL T�j� <br /> PERMIT VALIOATION <br /> WH[N PROP[AlV VALIOMEO (IN THISSPAC@)THI3IS VOUFl PCRM1IIT <br /> nPCULnTIONPGf.EiT[DBV: VLIINSCHCCY.EUBV: RPVPO�Tp(Q(11:SU�NCGBP. <br /> 1`�� <br /> !� <br />