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t/IE' ECITY�OF <br /> � CONSTRUCTION evereft I <br /> i everett �ERMIT I � <br /> I C1Y„All I59Btf; <br /> IVFP[i1,11A5HIIlGiUN <br /> 9G}01 <br /> "" °"°°':°""" BUILDING MECHANICAL PLUMBING <br /> OCYEIOol.1ENi <br /> OWNER MAII.ADOFESS ZIP PHONE <br /> '�'"�`F'�S �; SL%L� 13i�� <br /> .FCM fECT OH DESIGNER MAIL ADORE55 VHONE LICENSE NO. <br /> GEy4ERTAILCOf�TRACTOR MAILA�DHE55 PHONE LICENSENO. � <br /> �1; I <br /> P.1E.^.HANICAL CONTRACTOR MAIL ADOHESS PHONE LICENSE NO. <br /> PLUMBINGCONTRACTOR MAILADDRE55 PNONE �ICENSENO. � <br /> W <br /> m <br /> �ERMIT C1A55 OF WORK � <br /> Z <br /> �OUILDING �PLUM6ING �MECHANICAL F <br /> ❑NEW ❑ADOITION ❑ALTEPATION ❑REPAIR � <br /> VALUATIO/�y�yO�P W/yU�RK � <br /> 5 MMIM+�f ❑DEMOLISH ❑FGNCE SIGN ❑SWIMMING POOL w <br /> a <br /> �ESCRIBf WORK ��� <br /> F; .�n `.!it� �;�.p�-+r,.. .f�� <br /> PROPOSED VSE <br /> MECHANICAL <br /> LEGAI.OESCRIPTIONOF PROPEPTV (SHOW�ELOW Ofi ATTACH T�P�OP FUEL �OIL �GAj. �LPG. �ELEC. <br /> FOIJR COPIE51 <br /> �or B�OCK—oc NO. TYPE OF EOUIPMENT FEE <br /> AIR COND. UNITS-N.P. EA. S I <br /> PEFqIGERI�TIOIJ VNiTS-H.P. EA. <br /> — �OILERS-H.P. E�. � <br /> � GAS FIfiED A.C. UNITS-TONNAGE EA. <br /> � �`�--� _ _ FOqCEO AIR SYSTEMS-6.T.U. M EA. I <br /> JUO ADOFE55 �h� WALL HEATER;-�.T.V. M <br /> UNIT HEATEFS-�.T.U. M I <br /> EVAPORATIVECOOLERS <br /> PLUMBING CLOTNESORVbA$ � <br /> VENTILATION�AN �— <br /> PAN6EHD00 � <br /> NO. TVPE OF FIXTURE OR ITEM FEE nlq HAkDLING VNIT- QF.M. <br /> WATEftCLO5ETITOILETI E �NCWEPAiOR � <br /> onrr�rua <br /> LAVATOqY1WA5M0A51N) � <br /> SHOWGq — <br /> KITCMEN9NKRDISP. SUOTOTAL 5 . <br /> DISHWASHF.P � <br /> LAUNDFlY TRnv PLRMIT $ <br /> -'� TOTALFEE 5 � <br /> CLOTHFS WASHEH T195 PEHMIT BECOMES NULL ANO VOIO IF WOftK OF CONSTHUG <br /> WATCfi MEATEIi TIGN AUTHORIZEU IS NOT COMM[NCED WITNIN 12p DAYS. Oq IF <br /> UPINAL CO��TRVCTION OR WONK IS SUSPENDEO OR ABAIIDONED FOR A <br />, DRINKING FOUNTAIN PEfi1l.O OF 120 DAVS AT ANV TME APTER WORK IS COMMENCEO. <br /> FLOOR-SINK UR URAIN I HEPC'.Y CERTIFV THAT 1 NAVE REAO ANO E%AMINEU TI/IS AP- <br /> VACUUM ORF.AKER? PIiCAT1i:�N AND K�uOW THE SAME TO�[TRUE ANO COIifiECt. ALL <br /> PROVI510��5 OF lAVJS AND OflOINANCES GOVERMNG THIS TVPE <br /> ROOF DRAINS-RAINLEADCAS pF WORK WILI 6E C01dPLIED VJiTH WHETN[R SPEGFILD HLFEIN <br /> SINK (SERVICE-AAP, ETC.) OR NOT, THE GRANTING OF A PERMIT �OES NOT PFESUMF. TO <br />- qNE AUTHpRI7Y TO VIOLATE OR CANCEL TIiB PROVISIOf.15 Of <br /> ANY OTHEq STATE OR LOCAL LAW qEGUTATING CONSTRtiCTION <br /> _ OR TI/E°ERFOflMANCE OF f.ONSTRUCTION. <br /> SUP TOtAL <br /> PEPMIi $ <br /> _ TOTALfEE $ � <br /> x ts,l2t3Jii� <br /> SIGNAI'I.REOFf.ONTRACTORORAUTH.AGI:NT DAT[ <br /> SID[ VAflI]SETDACK STFE[TSLTOACK REARYAfiD5ET6ACKP�ANCHECKNUM6ER PLANCHECKFEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AFEA VACANT SIT[ <br /> ❑YES ❑No FEES VALUATION FEE <br /> TVPG OF LONST. OCCUPANCY GROVP NOAF DWEILING <br /> UNITS � <br /> SIZE OF BLDG. NO.OP STOflIES MA%.00Q LOAO DUILDING j �iiy <br /> PLUMBING I <br /> F�RE ZUNE OASEMENT FIRESPFINKLERS <br /> RfOUIRED <br /> ❑YES ❑NO MECHANICAL � <br /> SPECIAL CONDITIONS: OTHEfl � <br /> I <br /> — PF.NELTY SEC.JO71e) I <br /> TOTAL J �(� <br /> PERMIT VALI�ATION <br /> WHEN PROPERLY VALIpAT[D (IN TNIS SPACEI THIS IS VOVR P[qMIT <br /> A�PLILn110N aCCLPi(DIIY: VLANSfNECv,Cp�Y: RFPPCVC�FOR 6:UANCC'BY. <br /> L� <br /> � A <br /> � <br />