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tlrn Evcri/reen <br /> =�T��� CONSTRUCTItIN evec•ett <br /> everett PERMIT <br /> urvrau asaeens <br /> [VLNlIt,W45NINf10N <br /> satai <br /> °"`""°M"°""" BUILDING MECHANICAL PLUMBING <br /> nEVEiovAi[rvr <br /> OWNER M[11L AD�NESS 21P PMONE <br /> K�� � �� <�t� �� <br /> AFiCHITECT Ofl UESIGNER MAIL ADDRESS PHGNE LICENSE NO. <br /> GENERAL CONTRACTO+Ry�����, .�MnA�IL ADDRE55 PHONE LICENSE I�O. •5N']_� <br /> ZY� JLSl�i:p '�fiV Ix7 �'1P� rSLO�� �j� a�J'fJ� <br /> MECHANICAL CONTRACTOfl MAIL AO�RE55 PHUNc LICENSE NO. <br /> PLUM8ING CONTRACTOfl MAIL ADDflE55 PHONE LICFNSE NO. � <br /> W <br /> m <br /> PEflMiT CLASS OF WORI( � <br /> z <br /> �DUILOING � PLUMBING �MECHANICFL �- <br /> �NEW ❑ADOITION �ALTERATION ❑REPqIR � <br /> VALUATION OF WORK � <br /> g���Q� ❑DEMOLISH ❑F[NCE ❑SIGN ❑SWIMMING POO� a <br /> DESCPIBG WOflK — <br /> �-�. :�=_�t� �. ��+�a 1215 <br /> PFO�'OSED USE <br /> �,�� MECHANICAL <br /> LCGAL U65CRIPTION OF PROPERTY (SHOW OELOW OR ATTACH TYPE OF FUEL �OIL ❑uA5 �LPG. U ELEC. <br /> FOUft COPIE51 <br /> Lor—_ o�oCK—oF NO. TYPEOF E�UIPMENT FEE <br /> AIR COND. UNITS-H.P. EA. $ I <br /> REFRIGERl�TION UNITS-H P. EA. <br /> -- �OILE(75-h1.P. EA. � <br /> GAS FIFE� A.C. UNITS-TONNAGE EA. <br /> FORCGO nlq SYSTEMS-B.T.U. M Eq. � <br /> JOB �FLSS WALL HEATERS-�.T.U. M <br /> � C'���� VNIT HEATERS-B.T.U. M I <br /> EVAPORATIVECOOLERS <br /> PLUI�AB I NG CLOTHES D R V E RS � <br /> VENTILATION FAN <br /> HANGEHOOD � <br /> NO. TVPE OF FIXTURE OR ITEM FEE n�R MANOLING UNIT- C.F.PA, <br /> WATER CLOSET ITOILET) g �NCINERATOR � <br /> + UAlHTUO — � <br /> i_ LAVATORVIWASHBASIN) _ — � I <br /> f SIiOWER �� <br /> KITCNEN SINK & DISP. ;:Uu TOTAI � <br /> DISHWASHER PERMIT <br /> LAWVDRV Tf`AV TOTAL FEE 5 � <br /> CLOTHES WASHER THIS PFRMIT lfFCOMES NULL /�MD VO10 If iVOf1Y. Ofl CON6TltUC <br /> WAIhH HBAIEN TION AVTHORI2ED IS NOT COMMENCED WITHIN 120 DAYS, OR IF <br /> URINAL CONSTRVCTION OR YJOFK IS SUSPENDED pp ABANDONED FOR A <br /> ORINKING FOl/NTAIN PERIOO OF 120 OA�'S AT ANV TIME AFTEF\VORK IS COA9MENCE�. <br /> FLOOR-SINK CR�RAIN I HEREOV CEqTIFV THAT I HAVE READ AVD EYFMIN[D THIS AP� <br /> V4CUUM �REAKERS F'IICATION AND KNOW THE SAME TU DE TpVE AN�CORHECT. ALL <br /> ROOF DRAINS--qAINLEADERS PAOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE <br /> OF WORK WILL BE COMPLIED WITH WHETFIER SPECIFIED HE(7EIN <br /> SINK (SERVICE-0Aq, ETC.) OR NOT, TME GRANTING OF A PEFMIT OOES NOT PqESVME TO <br /> GIVE AUTHOPITV TO VIOLATE OR CANCEL THE P�OVISIONS OF <br /> ANV OTHER STATE O� LOCAL LAW REGULATING CONSiRUCTION <br /> OR THE PERFORMANCE Of- CONSTRUCTION. <br /> SUB TOTAL <br /> PERMIT 5 <br /> TOTAIFEE 5 ^ ^}qf <br /> x C1��1 !V <br /> SIGNATUREOFCON'iRACTORORAUTH.AGENT DATE <br /> SIDE VAftD 5ET0ACK STREET SETBACK REAR VARDSETBACK P�i1N CMECK NUM�ER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE 20NE LOT AREA VACANTSITE <br /> ❑VES ❑NO FEES VALUATION FEE <br /> TVPE OF CONST. OCCUPANCV GROUP NO.OF OWELLING <br /> UNITS � <br /> S12E OF BLDG. NO.OF STORIES MA%.OCC. LOAD BUILDING 5 ��J�� �� yy <br /> FIFE20NE BASEMENT FIREJ RINKLEFS PLUMBING � <br /> RE�UIREO <br /> ❑VES ❑NO MECh'FNICAL � <br /> SPECIAICONDITIONS: OTHER • � <br /> I <br /> PENELTV SEC.307(al I <br /> TO7AL �j �U <br /> PERMIT VALIDATION <br /> - WliEN PROPERLY VALIOATED IIN THIS SPACEI THIS IS VOUR PERh11T <br /> �YPLICATIONACCEPiFDBY�. PlFNSCMEIXf�OY: 4GFR�YlOF{yt�SLpAt¢COY. <br /> l� <br /> 3 <br />