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<br /> �°�� r=��,°�������,� _ CONSTRI�'CTION everett
<br /> ",v °` PERMII�
<br /> everett
<br /> Cll V Hr\Ll. 2!i9�U]AG
<br /> i-vEr�rrr, wn �x�o, COMBINATION • BUILDING • MECHANICAL • PLUMBING
<br /> OWNLH Ml11L ADDFGS$ ZIP PHON[
<br /> 'O
<br /> �:,��'1 Lal-:;::ti, �tt107. 75{:il S.iJ. . 9r'I'1_03 3.'i5-�174�i m
<br /> �
<br /> A(iCHIiECT OR DESIGNEH MAILAOORESS PIIpN[ LIGENSE NO. �
<br /> �
<br /> GENERA�CONTFiACTOR MAILAODRE55 PHUNE LICENSENO. z
<br /> :J 3q1Q
<br /> C
<br /> MECHANICAI CONTRACTOR MAIL/1DDRESS PHONE LICENSE NO. �
<br /> �iv��r�;rcen SiiceL- (�i�tal 0°
<br /> m
<br /> �'LUM6ING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. � 'A
<br /> i���r-Kcl E'luir.uin��� �
<br /> P�-EyRMIT CLASSOFWORK � .
<br /> �1.JCOh1BINATION
<br /> ❑111.'ILDING � I'LUM6ING �MECFIANICAL
<br /> •�NEW ❑ADDITION ❑ALTERATION ❑R[PAlfi
<br /> VALUATIONOF WORK
<br /> 5 Sn� �.G�I.00 ❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMINGPOOL
<br /> DESCRIBE WOflK
<br /> i-C11:;�'.L'UCi: ���C?4J iiE3i'.LI�CIICi?
<br /> PROPOSED USE
<br /> e; iri�.�l^. ftrni.l�:� r.e�idence MECHANICAL
<br /> LEGAL�ESCFIPTION OF PROPERTV ISHOW BELOW OF ATTACH T��'E OF EMBqGY
<br /> FOURCO,PIESI ��'n+ ❑ELEG.
<br /> i3CG;Or;I�IOOC� p7p, TVPE OF E�UIPMENT FEE
<br /> LOT �LOCK—OF
<br /> AIfl COND. UNITS-H.P. EA. $ �
<br /> REFRIGERATION UNITS �H.P. EA.
<br /> —'� BOILERS N.P. EA. �
<br /> � FURCEO AIR SVSTEMS-B.T.U. MEA. . ,
<br /> I
<br /> JOB ADDRESS SPACE K WALL HEATERS - B.T.U.
<br /> - .� j (� t'n'.91.^L' .\`✓Cllll:! -- UNIT HEMERS-B.T.U. I
<br /> FVAPORATIVE COOLEfiS ���,�
<br /> PLUMBING I CLOTHESOf1VER5 � i,�t)
<br /> V[NTILATION FAN T
<br /> � RANGEHOOD (�v�
<br /> NO. TVPE OF FIX7URE OR ITEM F.EE AIR IiANDLING UNIT- C.F.M.
<br /> '� BATH TUBS S '- ' �— - �
<br /> ! CLOTHES Wl�SHER �`�� �VqTF.Fl HEATER
<br /> 1 DISH WASH[RS � � � {-qC. BUILT FIREPLACE & CHIMNEY �
<br /> DfiINKING FOUNTAINS i -- --------
<br /> FLOOR URAINS � GAS. SVSTEM: NO OP OUTLETS T—
<br /> � KITCHEN SINKS & DISP. ' il l SUO TOTAL 5 � �1(
<br /> Bl�R SINKS � PERMIT 5 � -�,
<br /> ROOF DRnINS - RAIN LEADERS � TornL FEE 5 I-��.
<br /> SHOWEfl �ATHS �- �" THIS PERMIT fiGCOMCS NULL AND VUID IF WORK OR CONSTRUC
<br /> SEH\/ICE SINKS —T� TION /�UTIiOH12ED IS NOT COMMENCED WITHIN 120 DAVS, OH IF
<br /> SUMFS - SEIVAGE PUMP �UNSTRUCTION Ofi WO(iK IS SUSPENDEO OR 11UANDONED fOR A
<br /> � PERIOD OF 17.0 OAVS AT ANV TIME Af-TER WORK IS COh1MENCED.
<br /> UPiNALS
<br /> ' l'JATER CLOSETS �� I � HERE[3V CERTIFY 1HAT I IIAVE READ AND E%AMWEO THIS AV-
<br /> WATER HEATERS - ELECTRIC _ � �UCATION AND KNOW 7HL SAME TO OE TRUE AND COFRECi. ALL
<br /> � PROVISIONS Of LAWS ANf) OqDINl�?10ES GOVEFNING TIIIS TYPE
<br /> WASH BASINS i' '� OF WOI1K WILL UL GOh1PL1[D WITH WHETHER SPECIFIED HEFEIN
<br /> LAUNDRV TRAVS Oft NOT, TM[ GRANTING Of- A PENh11T �OES NOl PFlESUME TO
<br /> GNE l�UT110f11TY TO VIOLAT[ OR CANCEL TNE PfiOVISIONS OF
<br /> 4NY pTHflR STATE OR �OCAL ll�W REGULATING CONiTRUCTION
<br /> � OR TII[P[RFOfiMl�NCE OF CONSTftUCT10N.
<br /> 1
<br /> SU6TOTAL �'•�� ����
<br /> PERMIT 5 ' �' / /.��.
<br /> TOTAL PEE —�'��� �: ��'-`�/ � �l.i � .
<br /> WATER SERV'CE SIZE tlLDG. SUPPLV SIZE xcNnt VfSL���f�� �vo�. uni.n�i onrE
<br /> SIOEVARDSETOACK STREETS;TESACK HEA Y1RDSETPACKPL.'1NC11[CKNU�IFlCN PL.ANCNECKFEE
<br /> �('
<br /> " '-" '� FEE RECEIPTNO.
<br /> USEZONE LOTAPEl1 VACANTSITE / � � � �� � ���
<br /> ��-1 13�(lul �..yES ❑NO
<br /> FEES VALUATION FEE
<br /> TVPE OF CONST. OCCUPANCV GROUP NO.OF 1]WELLING
<br /> ��__� UNITS 1
<br /> 1 1 -
<br /> 512E OP OLOG. NO.OF STOHIES MAX.00C. LOAU ❑VILDING 5 i�� 1�]I.00 1�� � �)l)
<br /> 1 •:;�r' � �
<br /> ��� ' ] PLUM6ING z�� l �
<br /> PIREZONE 13.'...EMENT HRLSPHINKLEHS I
<br /> ? �r�+g RE�UIfiED
<br /> ❑V[5 �nNO MECHANICAL 1� �7'�1
<br /> -1--
<br /> SP[CIAL CONDITIONS:� OTHER �
<br /> �' Q
<br /> PENALTV SEC.90�1�1 �
<br /> --a=�-a- - - -- , �
<br /> � __ ' TOTAL ..� I%ii
<br /> —�C ... . .f�ijA��TN�r1��10(1L,��ATEDI�1�jIAI:jSPAC 1 S (IUHPLIih11T
<br /> CT� �Il.f� �( �./
<br /> -, 7 U 7 ir � j !��:�;�1 - 1
<br /> - � ,
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<br /> _ —�__._�_ R RECEtP7 c ;. , . �'OUR REG1EIf'�c'
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