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t. tc Ev�:r�n�cn <br />CITV Uf- <br />everett <br />❑tY IIAII }1)BAAS <br />lYCxfif 1v.\SIIINfipN <br />9B101 <br />�FP1. Of C051VIIIryIIy <br />oevuorninu <br />NER <br />l,lf.y�s Fi�:a <br />tFALCONTflACTOR <br />�. v u• u�4ii l`.q• <br />BUILDING <br />❑ BUILOING � PLUMBING � MECHANICAL <br />✓ALUATION OF WOqK <br />e� i:)�.f�.fl�°,� <br />7ESCRIBE WORK ' <br />c�rECL• lllcua.inat�c: s3;n <br />'ROPOStEO USE <br />�.{1Cf:1 <br />RTY'SHOW E3ELOW <br />LOT OLOCK__ <br />JOB AD�RE55 <br />G3�� L'v�rgrzen '�:ay <br />PLUMBING <br />T <br />I <br />n <br />SPECIAL CONDITIONS: <br />GOf'JSTRUCTION <br />PERMIT <br />MECHANICAL <br />F <br />PLUMBING <br />2 <br />�2 <br />OF WORK <br />❑NEW ❑AODITION ❑ALTEPATION ❑REPAIR <br />❑CGMOLISH ❑f-ENCE QSIGN ❑SWIMMING POOL <br />VARD <br />[�VES ❑NO <br />MECHANICAL <br />everett <br />.Lt)5�)--77 <br />AIR CONO. UNITS-H.P. EA. 5 I <br />REFRIGERATION UNITS-H.P. Eq. -7 <br />OOILEFS-H.P. EA. � <br />GAS FIRED A.C. UNITS-TONNAGE EA. <br />_ i <br />FOqCEO AIR SYSTEM5-f3.T.U. M EA, � <br />WALI.IiEATERS-B.T.U. M <br />VNITHEATEFS-B.T.U. M � <br />EVAPORATIVECOOLEftS <br />CLOTHESDRVEPS � <br />VENTILATION FAN -�' <br />RANGE Ii00D � <br />I <br />AIR HANDLING IJNIT- r c �n � <br />SU� TOTAL 5 � � <br />PEFMIT 5 <br />TOTAL FEE S I <br />� <br />THIS PERh11T �ECOMES NULL AND VOIO IF WOFK OR CONSTRUC� <br />TION AUTHOflIZED IS NOT COMMENCED WITHIN 120 DAVS, CR IF <br />CONSTFiUCTION OR WOqK IS SUSPENDED OR ADANDC4EP FO(1 A <br />PERIOD OF 120 DAVS AT ANY TIA1E AFTER WORK IS COMMENCED. <br />I HEREDV CERTIFV THAT I NAVE READ AND EXAMINED T�115 AP� <br />PLICATION AND KNOW THE SAhiE TO DE TRUE AN� CORREC7. ALL <br />PROVISIONS OF LAWS AN� OPDINANCES GOVERNING THIS TVPE <br />OP WORK 1NILL DE COMPLIED WITH WHETHER SPEGFIEO HEFEIN <br />OR h!OT, Th1E GRANTING OF i1 PERMIT DOES NOT PRESUAI[ TO <br />�:IVE AUTHORITY TO VIOLATE Ofi CANCEL THE PqOVISIONS GF <br />t NV OTHER STATE OR LOCAL LA4V REGUI.ATING CONSTRUCTION <br />Oft THE PERFORMl�NCE OF CONSTRUCTION. <br />X �%�z7.�$si <br />iIGNATUFEOFCONTRACTORORAUTH.AGENT DATE <br />LAN CHECK NUMftER PLAN CHECK FEE <br />FE[ RECEIPT NO. <br />FEES VALUATION FEE <br />IE3 MAX.00C.LOAD DUILDINU 5 1•l.7UV.UU j�,yx�LL <br />ls <br />PLUM8ING ---� <br />FIRESPRINKLERS � <br />REOUIfiED � <br />❑YES ❑NO MECHAfJICAL � <br />I <br />OTHEP I <br />I <br />PENELTY SEC.30� (al (y �;� <br />TOTAL �`��Y <br />PEqMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THISSPA�F� THIS IS VOUR PEqM1T <br />�' ■ <br />