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- ,� <br /> ' rne Evo.9a,en � <br /> ' �,r� �� CONSTRUCTIOIV everett <br /> everett PERMIT <br /> I CIIY IIAII I5902P.5 <br /> FVENRi,IYAS�IINfiO�l <br /> 931i11 <br /> �E�� ��_��°������ BUILDING MECHANICAL PLUMBIN <br /> nevEinve,�r�r <br /> MAIL AODRESS PHONE <br /> i OIVNEft.: . �(� ._., ZIP Cli�';/�3 <br /> ..1 i •''�?.�Tla ��JaW' J: ' <br /> IAftCHITECT OF DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br /> GENERAL CONTRACTOR MAIL AODRE55 PHONE LICENSE NO. <br /> �i�.l� <br /> MECHANICAL CONTRACTOR MAIL AODIlESS PHONE LICENSE NO. <br /> � <br /> PI.UMBING CONTRACTOR MAIL AODRES� PHONE LICENSE NO. W <br /> m <br /> � <br /> PERMIT CLASSOFWOFk � � <br /> z <br /> yp�6UIlDING ❑ �'LUMAING ❑MECHANICAL ~ <br /> ❑NEW U�+DDITION ❑ALTERATION ❑REPAIR � <br /> � <br /> VAWATION OF.1ypI3F� W <br /> ��N�J�Ui �pEMOLISH ❑FENCE ❑SIGN ❑�W�h�MING POOL � <br /> S _ _ q <br /> �ESCRIOE WORY. �..--�.T �.,.t `'. . .,...�, V O V <br /> PROPOSEO USE MECHANICAL <br /> TVPEOf- FUEL �OIL ❑Gn5 LLPG. �ELEC. <br /> LEGAL�ESCRIPTION OF PRO�'[RTV ISHOIV 6EWW ON l�TTACH <br /> FOUFi��GO, PJ,�51 „„q �..-�• .-�--y��fr �a NO. TYPE OF E�UIPMEN7 FEE <br /> LOT `"�J:IBLOCK +�'i'�rOF_ ''t.,:-.liil!;.4 RJ I�:vs � <br /> AIR COND. UNITS-H.P. EA. 5 <br /> I REFRIGERATION UNITS-H.P. EA. <br /> �OILERS-HP. EA. � <br /> I — GAS FIFED A.C. UNITS-TOMNAGE EA. <br /> FOftCED AIR SYSTEMS-B.T.U. M EA. � <br /> I JOB ADORESS �`;'� � '.'� W�+LL HEATEFS-B.T.U. M I <br /> I UNIT HEATERS-B.T.U. M <br /> _ EVAPOFiATIVECOOLERS <br /> PLUMBING CLOTHESDRYERS � <br /> I VENTILnTION FAN <br /> --r'— <br /> FANGEHOOD � <br /> Alk NANDLING UNIT- 0.F.M. <br /> NO. TVPE OF FIXTUOE OR ITEM FEE INGiNERATOR � <br /> I WATER CLOSETITOILET) 5 — — <br /> BATHTUB � <br /> LAVATOFY(WASH BASIN) <br /> I SHOWER — <br /> SUB TOTAL S 1 <br /> KITCHEN SINK& DISP. � <br /> PERMIT 5 <br /> DISHWASHER <br /> LAUNDFV TRAY _ TOTl1L FEE 5 I <br /> CLOTHES WASHER 1HIS PERMIT OEGOMES NULI AND VOID IF WORK OF CONSTRUG <br /> WATER HEATER TION AUTHORIZED IS NOT COMMENCEO W�THIN 120 DAVS, OR IF I <br /> CONSTRVCTION OR WORK IS SUSP[NDED OR ABANOONED FOR A <br /> UFINAL pEFIOD OF 720 DA1'S AT ANV TIME AFTER WOPK IS COMMENCEO. <br /> ORINKING FOUNTAIN <br /> FLOOR-SINK OR DRAIN I NEftE6� CEFTIFV THAT I HAVE READ ANO EXAMWE� THIS AP- <br /> PLICl�TION AND KNOW THE SAME TO �E TRUE AND CORFECT. ALL <br /> VACUUM OREAKERS — PROVISIONS OF LAWS AND ORDINANCES GOVEftNING THIS TVPE <br /> ROOF ORAINS-RAINLEADERS OF N'ORK WILL BE COMPLIED WITH WHETHEF SPECIFIED h:EftEIN <br /> SINK (SERVICE-�DAR. ETC.) �R NOT, THE aRANTING OF A PERMIT DOES NOT PfiESUME TO <br /> GIVE AUTIIOFITV TD VIOLATE OR CANGEL THE PROVISIONS OF <br /> ANY OTHER STATE Ori LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFOFMANCE OF CONSTRUCTION. <br /> SU6 TOTAL <br /> P'cRM1T S ,.�} <br /> TOTAL FEE 5 fiqj1�(L <br /> X <br /> SIGNNTUREOFCONTRACTORORAUTH.AGENT Dl1TE <br /> SI�E YAflD SETBACK STREEI SET�P.CK REAR�'AROSETBACK PLAN CHECK NUMeER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE 20NE LOT AREA VACANT SITE <br /> ❑VES ❑No FEES VALUATION FEE <br /> T�PE OF CONST. OCCUPANCV GROUP UNITO.^ DWELLING � <br /> SIZE OF BLDG. NO. OF STORIES MAX.00Q LOAU F3UILDING 5 ��� ^' �^ <br /> I <br /> PLUMBING � <br /> '� FIRE20NE BASEMENT FIFESPRINKLERS � <br /> I H["QUIFED � -- <br /> ❑YES ❑NO MECHA�IICAL <br /> I <br /> SPECIAL CONDITIONS: OTHER I <br /> PENELT� SEC.3031a) � <br /> I <br /> TOTAL {�S �I <br /> I PERMIT VALI�ATION <br /> WNEN PflOPEFLV VALIOl�TED UN THIS SPACEI TNIS I;VOUR P[FMIT <br /> APPLIC�LIO!IACCfPTCO[IY�. PLFNvLH[CNEOOY�. AVPflOVEDF01 ISSU���CEBY. <br /> � � � <br /> � <br />