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- - :=., . <br /> r�tr, E�,>a,�eY„ .. <br /> ��T� �F: CONSTRUCTION everett <br /> everett PERMI�� <br /> ��r.,,a<< �s�sFa, <br /> �v[Hnr,rcasnrvcme <br /> v3ini � I , <br /> '�°`°o.`�E;op;;E„; BUILDING MECHANICAL PLUMBING �+� <br /> OWNEN I <br /> `�,��y ��,�r3 �1 Mn�tAITLM ADDRESS ZIP PHDNE <br /> •aii �� �• �-Lc-A W'�• �i�(`� I <br /> 1�7 <br /> AflCHITECTORDE5IGNER MAILADDFESS PHONE <br /> LICENSE pA. <br /> GENERALCONTRACTOfl MAILADDRES£ PHONE <br /> ���� ..,,x,3��,y LICENS_ NO. <br /> 1V <br /> MECHANICALCONTqACTCF. rv111LAGGncSa PHONE <br /> LICENS� NO. <br /> PWM6INGCONTRA(.TOq MAILADDRESS PNONE � <br /> I.IC�NSE �10. W <br /> m <br /> PcPM1T CLASS OF NORK � <br /> � � <br /> L�',DUILDING PLUMBIMG z <br /> ❑ ❑AIECHANICAL <br /> ❑NEW ❑(�DDITION ❑ALTERATION �REPA�q ~ <br /> VALUAl10�Ny yO�F WOFK � <br /> 5 JJVp� ❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL W <br /> �F.SC(il6f WURK 6. <br /> ��?+' (G�) 4�7 <br /> PRO:'/>SED USE <br /> MECHANICAL <br /> LEGAL Lc'SCRIPTIOh OF PftOPERTY (SHOW�ELOW Oq q7TACH TrPE OF FUEL �OIL �Gns. nLPG. �E�EC. <br /> FOUR C��`ESI <br /> 7 <br /> ���>? --- uLocK_oF �' r��'_ � � � NO. TYPE OF FaUIPMENT <br /> FEE <br /> � AIF CON�. UNITS-H.P. EA. 5 I <br /> REFRIGERATIONUNIT.^.-Ii.P. EA. —� - <br /> '.. ...._.-�.. DOILERS-�H.P. EA. <br /> _i <br /> GAS FIRED A.C. UNITS-TONNAGE EA. r <br /> FORCED AIR SYSTEMS-B.T.U. M Cq. � <br /> JOD A�DqESS yyqLL HEATEFS-B.T,U. p� I-- <br /> i �� �� �i �U _ UNIT HEATERS-B.T.U. �� � <br /> 1 <br /> • FLUMBING EVAPORATIVECOOLERS <br /> I:LOTHES�RYERS � <br /> VENTILATION FAN <br /> RANGENOOD � <br /> NO. TYPE OF FIXTURE OR ITEM AIF HANOLING UNIT- C.F.M. <br /> _ �WATEF CLOSET ITOILETI g��- INCINERATOR � <br /> 3ATHTUB <br /> _ LA\'ATORV(WASH�ASINI � - I <br /> SHOWEF <br /> KITCIIEN SINK R DISP. SUB TOTAL 5 <br /> DISHWASHER � <br /> LAUN�RY TflAY PERMIT 5 —�-- <br /> CLOTHES WASIiC-R TOTAL FEE S � <br /> Wl1TGq HEATER ' THIS P[RM171T �[COMES NULL ANO VOID IF WpHK OR CONSTRUC� <br /> VRINAL — TION AVTNORIZEO IS NOT COhiMENCED WITHIN 170 DAVS, OR IF <br /> _ CONSTRUCTION Cft WORK IE SUSPLNDEU OR A6ANDONE� Fpq /� <br /> DRINKING FOUNTAIN PERIOD Of 120 DAYS AT ANV TIME AF7ER WORK IS COMME4CED. <br /> FLOOH-SINK OFl URAIN I HEREO\' CERTIFV THAT I HAVE READ AND EX/�M111NED THIS AF� <br /> VACUUM �qEAKLRS P�ICATION ANO KNOW THE SAM17E TO�E TRUE ANO COPRECT. ALL <br /> FOOf- ORAINS-RAINI.EADEFS P�OVISIONS OF LAWS ANO OR�INANCCS GOVERNING THIS TYPE <br /> SINK ISERVICE-IIAR, ETC.) �F WOFK WILL 6E COAtPLIED WITH WHFTHER SPLCIFIED HEREIN <br /> --- Ofi NOT, THE GRANTING OF q PERh11T OOES NOT PRESUME TO <br /> GIVE I�UTHORITV TO VIOLA7'L OR CANCEL T�{E PROVISIONS OF <br /> — ANY OTHER STATE OR LOCAL LAW REGULMING CONSTfiUCTION <br /> SU0 TOTAL �R TI1E PEFFORM�INCE OF CONSTRVCTION. <br /> PERMIT $ <br /> ____ TOTAL FEE $ <br /> x �� <br /> SIGNATVFGOFCONTRA�TOROftAUTH.AGENT DA"!E <br /> SIDE VAflDSETBACK ISTREETSET�ACK REARYAFDSETBACK PLANC4IECK NUMUER <br /> PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> ❑Yts ❑NO FEES VALUATION FEE <br /> TVPF OF CONST. OCCUPANCV GROUP NO.OF DWELLING —r--- <br /> UNITS <br /> I <br /> SIZE OF BLDG. NO.OF STORICS MA%.00C. LOAD BUILDING 5 � � MY1 <br /> M� <br /> —I-- <br /> FIREZONE OASEMENT FIRESPRINKLERS P�UMOING � <br /> REOUIHED � <br /> ❑VES ❑NO MECHANICAL � <br /> I <br /> SPECIAL CONDITIONS: <br /> OTHER 1 <br /> I <br /> PENELTV SEC.J0�la) � <br /> TOTAL 1 � <br /> PERMIT VALIDATION <br /> WHEN PROPER�Y VALIDATED (IN T�IIS SPACEI THIS IS VOUfl PERh11T <br /> - I � <br /> �pPUf.�TIONAf.CIPifUI1V�. n�pry5C11CCKCOBY: AVPqOVEDFONI5Sl1ANLCBY. I <br /> u C. <br /> �, <br /> —.�� <br />