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\ <br /> �� <br /> i l�IC ('�t'C(IfIPCII � <br /> ��,� ��: CONSTRUCTION everett ` <br /> everett PERMIT �� <br /> ❑LY IIALI )59flAfl5 <br /> EVEIICiI.NALIIIlGiON <br /> 9;11111 <br /> �E�� �,��°•'��°'���° BUILDING MECHANICAL PLUMBING � <br /> urvrinrr.rtxt � <br /> OWNLfi MAILAUDHE55 21P �'HONE <br /> �.. ..+, .r.R. ....I...{. ,,.e.. ..a�1^"!�!� »l��i{ <br /> AFCHITECTORUESIGNER MAILAD�RE55 PHONE LICENSENO. <br /> GENERALCONTRACTOR MAILADDRESS PHONE UCENSENO. <br /> ..�:--Z?�� f..;"�",_.r . <br /> h1ECh1l�NICAL CONTFACTOR MAII AOORESS F�iONE LICENSE NO. <br /> � <br /> PLUM�INGCONTRACTOR MAILADORESS PHONE LICENSENO. �yJ <br /> m <br /> � <br /> PERMIT CLASS OF WORK � <br /> z <br /> ❑UUILDING ❑ PLUMOING Vy�iECHl�NICAL ~ <br /> �NEW ❑A�DITION ❑�+LTERATION ❑REPAIR � <br /> � <br /> VALUATION OF WORK W <br /> ❑�EMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL a <br /> 5 <br /> OESCRIBEWORK . .��,.r 'T'.'`.'Y .� _��. . ._.1". " . ....?y.. ., �iU '!994• <br /> . , . _ p � . . . . . . . . . <br /> PqOPOSEU USE MECHANICAL <br /> TVPE �FFUEL �OIL ❑Gn5 ❑LPG. �ELEC. <br /> I LEGAL OESCRIPTION OF NROPERTV ISHOW 6ELOW OF ATTACH <br /> FOUR COaiEsl Np, TYPE OF E�UIPMEN7 FEE <br /> LOT OLOGK—OF qIR CON�. UNITS-H.P. EA. 5 � <br /> REFRIGEFATION UNITS-H.P. EA. <br /> BOILFRS-H.P. EA. � <br /> GAS FIRED A.C.UNITS-TONNAGE EA. <br /> I PORCEO l�IR SVSTEMS-F3.T.U. M EA. � <br /> I JOO ADDRE55 rv+ WALL HEATERS-6.T.U. M <br /> I 1 JC'J j:`..,:.,,^'„..-,.,; 'F:yl � <br /> r�.. UNIT HEATEftS-A.T.U. M <br /> EVAPORATIVECOOLERS <br /> PLUMBING CLOTHES URYERS � <br /> VENTILATION FAN <br /> I RANGEHOOO � <br /> I <br /> I AIR HANDLING UNIT- 0.F.M. <br /> NO. TVPE OF FIXTURE OR ITEM FEE iNCINEnn7oR � <br /> WATERCLOSETITOILETI 5 � �» . <br /> I BATHTUB — — � <br /> LAVATORY (WASH BASIN) <br /> SHOWEIi <br /> KITCHEN SINK& DISP. SU6 TOTAL 5 —�I�I7q�� <br /> � DISHWASHER PERMIT 5 ,�'w <br /> I LAUNDRV TfiAV TOTAL FEE 5 �'� <br /> I <br /> I CLOTNL. 'NASHER THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTFUG <br /> VJATER HEATER TION AUTHORIZED IS NOT COMMENCE� WITHIN 120 OAVS, OR IF <br /> I CONSTRUCTION OR WOFK IS SVSPEN�ED OR ABANDONE� FOR A <br /> URINAL PERIOD OF 120 �AVS AT ANY TIME AFTER WOFK IS COMMENCED. <br /> II DFINKING FOVNTAIN <br /> FLOOR-SINK Oli �RAIN I HEPEBY CERTIFY TNAT I NAVE RLAD AND EXAMINE� THIS AP- <br /> I PLICATION ANO KNOW THE SAME TO�E TRUE ANO COflRECT. ALL <br /> VACVUM BREAKERS PROVISIONS OF LAWS AND OftDINANCES GOVE3t�ING THIS TYPE <br /> I ROOF DRAINS-RAINLEA�ERS ' OF WORK 1NILL dE COMPLIED WITH WHETHEFISPECIFIED HENEIN <br /> SINK (SEFVICE-DAR,ETC.) OR NOT, THE GRANTING OF A PERMIT OOES NOT PFiESVME TO <br /> GI�/E AUTHORITV TO VIOLATE OR CANCEL THE PFOVISIONS OF <br /> ANV OTHEF STATE OF LOCAL LAW REGUL4TING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> f SUB TOTAL <br /> � PERMIT 5 <br /> TOTA�. FEE 5 `_,_ ��,��}� !f.-i!'Y (�LS�.PrT <br /> x lly 4"�a'Vw •.7 �T �'/ <br /> SIGNATUR@OFCONTRACTORORAUTH.AGENT DnT[ <br /> I SIDE YAfiD SETOACK STREET SET6l�CK REAR VAROSETBACK PLAN CHECK NUM[1Efl PLAN CHECK FEE <br /> FEE RECEIPTNO. <br /> II <br /> USE ZONE LOT AREA VACANT SITE <br /> j ❑VES ❑No FEES VALUATION FEE <br /> � TVPE OF CONST. OCCUPANCV GROVP NO.OF GWELLING � <br /> I UNITS <br /> I <br /> II SI"LE OF BL�G. NO. OF STORIES MAX.00C. LOA� DUILDING 5 I <br /> PLUMBING � <br /> I FIREZONE BASEMENT FIRESPHINKLEftS �('�`� — <br /> qCQUIRED p1ECHANICAL �� ""' <br /> ❑YES ❑NO <br /> I <br /> SPECIAL CONDITIONS: OTHER I <br /> I _ PENELTY SEC.J07 fal � <br /> I <br /> �� TOTAL �C �� <br /> I PERMIT VALIDATION <br /> WHEN PROPERL� VALIDI�TED(IN THIS SPACE)THIS IS'/OUR PERMIT <br /> N'PLILATIONF6EFTEOOY'. �l�N5C11EGNEDBY: FPPPOVL�FO��I;SUFNCLOr <br /> ��� <br /> I <br /> IIt <br /> � <br />