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�' <br /> C���� �'� �J�'�'!��" everett <br /> ���, °` PEF�MiT <br /> �v�erett <br /> ci�� nn�� zs�a�ns . gU�LDING • MECHANICAL • PLUMBING <br /> � vEaerr, wn eszoi COMBINATION <br /> i',VJNER NAIL �1pDFE:iS LIV PHUN[ .9 <br /> . � __:t�s. L �- i,� � � <br /> AHCHITECT OF DESIGNF R � \1AIL /�pDfiE55 PHONE LICENSL fh0. � <br /> � <br /> GENERAL CONTRACTOR MAIL AOORESS PHONE LICENSE NO. z <br /> � . F�. , 'Sg-71:;1 : ;'�-Ol-lil' Li: LB "OL Pi C <br /> crett l;ui.l;:ur; _ c`:cY;,ree:: �; � <br /> ' PHONE LICENSE NO. 5 <br /> MECHl1MICAL CONTRACTOR M1IAIL A�DRESS . QJ <br /> m <br /> � <br /> PWh1131NGCONTRACTOR MlILLAO�FESS PHONE LICENS[ NO. <br /> PERMIT CLASSOFVJORI:-�---- "�'�—" -�--- '--- - <br /> ❑COMBINATION <br /> ❑�OVILDING ❑ �'LUMOING �MECHANICAL ONEW ❑�1DDITInN ❑/��.1[lil�IIUN ❑HCPNH <br /> VALUATION OF WORK <br /> ";0,�!! ❑oennousi� ❑r=crvcE ❑sicN ❑swiM�uri�; ��oo� <br /> 5 ^ ' ----—— - -- <br /> DESCRI6E WORK ' <br /> OLL�C:^CLO�� U`,1VC _.:13C1.-- -!Vit;. _ <br /> PROPOSED USE MECHAP:ICAL <br /> :Lil�,1C ' �'t:;1�.�• .-C'1r1i:ACC -.__--_ <br /> � TYPE OF ENBP: � <br /> IEGAL DESCRIPTION OF PROPERTV ISHOW 9ELOW OR ATTACH ❑�q5 ❑ELEC. <br /> FOU. ,,ICQ�PIE51 '�..�� <br /> � I �3,�. P.`�'cCeL't Oi�: t� NO TVPEOFE�UIPMENT FEE <br /> LOT-- BLOCK—OF � — AIR COND. UNITS—H.R EA. S � <br /> _— _�— <br /> REFRIGERATION UNITS �H.P. EA. . <br /> pOILF.FS H.P. LA --"" � <br /> FOFCED AIR SVSTEMS-B.T.U. MEA �— <br /> "-_ I <br /> JOl3 AGCiiE55 � SPACE R WALL HEATERS - B.T.U. <br /> ' �..: �.. . , . . .. �� UNIT IIE�ITERS-�f1.l.U. � <br /> _�LVAPONATIVE COOLERS <br /> PLUMBING C�OTIiES DRVLFS __� <br /> - -I VENTILMION FAN <br /> � RANGEHOOD � <br /> FEE AIR NAN�LING UNIT-- Qf.M. �—r— <br /> NO. TYPE OF FIXTURE OR ITEM __ __ — <br /> BATH TU[3S 5 - I <br /> CLOTHES W�ISHER � WATEH HEATEfl -- <br /> DISH WASHERS � FAC. 6UILT FIREPLACE & CIiIMNEV T_ <br /> DRWKING FOUNTAINS � -� ,AS. SYSTEM�. NO OP OUTLETS _ <br /> - � _._-.__----- -. - <br /> FLOORDftAIN$ .- -- � SUUTOTAL 5 I <br /> KITCHEN SINKS & DISP. � -' --- --'-- pEnMiT 5 <br /> BAH SINKS i __-.._-.-_---__ ._- _- _-- <br /> TOl'�1L FEE 5 I <br /> ROCF DRAINS - RAIN LEl10ER5 � __ _ _- - <br /> SHOWER 8ATH5 __ TIirS PF.FlMIT 6EC0'Af'S IJULL l�ND VOID IF WORK OF CONSTRUC� <br /> TIOM1 AUTHORIZEn IS NOT COMMENCED WITHIN 120 DAVS, OR If <br /> SEflVICE S�NKS CONS-i RUCTION OR WOHK IS SUSPENDE� OH A�l1NDONLD FOIi l� <br /> SUMPS - SEWAGE PUMP � _ PERIOG O� 120 DAYS AT nNY TIME liFTER WORK IS COMMENCED. <br /> UHWALS - � HERL(1�� CERTIFV THnT I HnVE FEl1O AND E%l�MWED THIS l�P <br /> WATER CLOSETS t- PLICAil01� �1ND KNOW TIIE':AM[ TO 6@ TRUL l�N� COFiRECT. ALL <br /> WATER HEATERS - ELECTRIC � PROVISIONS OF Ll�WS AND OR[�IN/�NC[5 GOV[fiNING THIS TVPG <br /> WASH 6�1SINS i OF WORK WI� L [3[ COMPUEO WITII WHETIIER SPECIPIED HEREIN <br /> LAUNORY TRAVS Oli NOT. TH[ Sf1ANTl`JG OF !� �'ERM111T DO[5 NOT PF[SUME TO <br /> i - GIVE AUTHORII V TU VIOI.ATE OR CANCEL THE PPOVISIOf�S OF <br /> ANY OTIiLR STl�TL OH LOCnL Ll�W REGULATING CONSTRUCTION <br /> 1 pfi TRE PEl�FOfiMANCE OF CONSTRUCTION. <br /> I <br /> SUB TOTAL � /�� ��� . <br /> PERMIT S // /l ,7 � �L% ].-.. <br /> TOTAL FEE X ��C2D�,�i��G'i� � _ <br /> WATERSERVICE512E BLDG. SUPPLVSIZE SIGNnTU�j«��CONr(vnCTOAorrnUTN.nGEUT onTE <br /> SIDEYnRD5ET6ACK STftEETSETOl1CK fiLl�RVARDSGTfl/1CKPLANCII@CY. NUMIi[R PLANCHECKFEE <br /> , FGE fi[CEIPT IJO. <br /> USE ZON[ LOT ARG/� VACANT SITE <br /> ❑vEs ❑uo PEES VALU�.TION FEE <br /> TYPE OF CONST. OCCUPANCV GROUP UN.'OS OWELLIhG I <br /> � <br /> S ���:�1.��. % �� � n'�1 <br /> SIZ[OF BLDG. NO. OF STORI[5 MAX.00C. IAAD AUILDING _ <br /> I <br /> PLUMpING � <br /> ItI1EZONE f3ASEM[Ni f-IRESP'iINKLEHS — � <br /> 'i ❑YEREU nN� MECHANICAL _ � _ <br /> -- I <br /> srec�n�.coNo�rioNs� or��eri I __ <br /> -- _- - - — 'T_ <br /> P[N�1LiV SF.C. 3031a) � <br /> ._.___-______ <br /> I <br /> _.. ._ ._ _ --_ _ ._- � I <br /> - TOTAL .��' I '��l <br /> ....- PERM17ITVALIDATION . t �' �; �,A�Q_A11. ' <br /> win_Nvi:nri_r{�.vvni.iun��n �osi ii r•nc P 504#�W�'e-rir.v <br /> - - - ' � - � - �' 1 <br /> . . <br /> __ - ,��u�a R�c�i� <br /> ---- - ?HA�tK YO�d <br /> n��rur.r.uuunccu�im�rv�. rinrvs'cner.K�uur. nrrnov�uiouir•�,nnri�iin � <br /> �� � <br /> • � � • <br />