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� t/re EvC�grcen <br /> ��T� �� GONSTRUCTlON everett <br /> everett PERMIT � <br /> cnr��nu aseaas <br /> NEPfIi.A'14SIIIN4LON <br /> °��' °°°°�.,^'°�°��� BUILDING MECHANICAL PLUMBING � <br /> a[vctavmcxr <br /> OWNER M/11L ADDflESS ZIP PHONE <br /> VOTA :•'`:'IY'k�lki �� �tL?.ml'C�B�. � � <br /> ARCNITECT OR DESIGNER MAIL A��FE55 PHONE LICENSE NO. 2�«.`� <br /> � <br /> GENERAL CONTRACTOfl MAIL ADDFESS PHONE LICENSE NO. <br /> MECHAN�ICA�L CONTFACTOR MAIL ADDRESS PHONE LIC[NSE NO. <br /> PLUMBING CONTRACTOR MAIL A�DfiESS PHONE LICENSE NO. � <br /> W <br /> m <br /> PERMIT CLA55OF WOflK � <br /> ][ Z <br /> rJ 6UILDING ❑ FLU�181NG �MECHANICAL � <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑R[PAIR � <br /> VALUATION OF WORK� � <br /> Mn ❑DEMOLI511 �FENCE ❑SIGN ❑SWIMMING °OOL W <br /> s c�ra1 a <br /> OESCRI�F.WOiiK �/��� <br /> LQ° C't�A L4ade =anra-�I'J4� Fc�e�C ia :�tie b <br /> PROPOSED VSE MECHANICAL <br /> TYPEOFFUEI �OIL �NAT. �LPG. �ELEC. I <br /> LEGAL OESCRIVTION�PROPGRTY ISHOW DELOW 0Ii ATTACH �'�' <br /> FOUR�y/_F'IESI <br /> LOT.IJ� OIOCK_OF ���'�'�'` NO. TYPEOF EQUIPMEN7 FEE <br /> S T� AIR CONO.UNITS-H.P. EA. S I <br /> REFRIGERATION UNITS-H.P. [A. <br /> [301LER5-N.P. EA. I <br /> Gl�S FIRED A.C. UNITS-TONNAGE EA. <br /> FORLED AIN SVSTEMS-B.T.U. M EA. I <br /> JOB ADDRE55 WALL HEATERS-�.T.U. M <br /> �' �� UNIT HEATERS-B.T.U. M I <br /> EVAPORATIVECOOLERS <br /> PLUMBING CLOTNESDRVERS I <br /> VENTILATION FAN <br /> RANGEHOOD � <br /> NO. TYPE OF FIXTURE OR ITEM FEE n�a HANDLtNG UNI7- C.F.M. <br /> WATER CLOSETITOILETI S �NCINERA70F I <br /> DATHTUO <br /> LAVATOHV (lVASN BASIN) � <br /> $HOWEP _ <br /> KITCHEN SINK& DISP. SU�TOTAL 5 � <br /> DISHWASHER PERMIT 5 <br /> LAUNOftVTPAY TOTAIfEE 5 � <br /> CLOTHES WASHER THIS PEFMIT UECOMES NULL AND VOID IF WORK OF CONSTRUC� <br /> WATER HEATER TION AVTNORIZED IS NOT COMM1IENCE� WITHIN 120 DAVS, OR IF <br /> URINAL CONSTRUCTION OR WORK IS SUSPEN�ED OP A�.INOONED FOR A <br /> DRINKING FOUNTAIN PEitIOD OF 120 DAVS AT ANY TIME AFTER WORK IS COMMENCEO. <br /> F�OOR-SINK OR ORAIN I HEREBY CERTIFY THAT I HAVE REAO AND EXl�MINED THIS qP� <br /> VACUUM BREAKERS PLICATION ANO KNOW THE SAM11E TO 6E TRUE I�ND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOV@RNING THIS TYPE <br /> HOOF DRAINS-qAINLE/1�[RS OF WORK WILI BE COMPLIEO WITH WHETHER SPE;IFIE� HEREIN <br /> SINK (SERVICE-Dl�P, [TC.1 OR NOT, THE GRANTING OF A PERh11T DOES NOT PRESUME TO <br /> GIVE AUTIiORITV TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANV OTNER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTFUC?ION. <br /> SUBTOTAL <br /> PERMIT 5 <br /> TOTALFEE 5 <br /> x �.�v���G <br /> SIGNATVREOFCONTRACTOf10RAU7H.AGENi DATE <br /> I S�DEVARDSETBACK STREETSETBACK HEARYARDSETBACKPLANCHECKNUMBER PLANCHECKFEE <br /> FEI? RECEIPT NO. <br /> �I USE ZONE LOT AREA VACANT SITE <br /> I ❑vE5 ❑No FEE$ �/ALUATION FEE <br /> TVPE OF CONST. OCfUPANCV GROUP NO.OF OWEILING � <br /> UNITS <br /> SIZE OF BLOG. NO.OF STORIES MA%.OGC. LOAD BUILDING 5 Q�yy � C�� <br /> I PLUMBING � <br /> FIRE20NE BASEMENT FIRESPRINKLERS <br /> RCOUIRED <br /> ❑VES ❑NO MECHA�lICAL 1 <br /> I SPECIALCONDITIONS: OTHER � <br /> PENELTY SEC. 303(al � <br /> TOTAL ,71 �) <br /> PERMIT VALIDATION <br /> WHCN PROPERLY VALIDATED IIN THISSPI�CEI THIS IS YOUP PERMIT <br /> AVYLICATIONACCEPTCOBV� PLrlNSCHECKEOBY: APVIIOVEUlOdL'SUnNCCRV <br /> ^�r <br /> 0 <br />