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tAe Evcrgrcen <br />arv or- <br />everett <br />urrnnu >s9ee�s <br />EVEPER. CrLS�IIpLTON <br />�asoi <br />oEPr o<«�.,,.,��,�.. gUILDING <br />ocveiarr.�eru <br />CONSTRUCTION <br />PERMlT <br />MECHANICAL PLUMBING <br />everett <br />OWNER MAILAODRE55 Z�P PHONE <br />3• SYt'3 �#� L".&i''?'.!, ''il. 3�;'3�'-%ai� <br />AHCHITECTORDESIGNEF MAILAOORESS PHONE LICENSENO. <br />GENERALCONTRACTOR MAILADDFE55 PHONE LICENSENO. <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />�` iWLit� y!`�.L• � <br />PLUM�IN� CONTRACTOR MAIL ADDRE55 PHONE LICENSE NO. �yJ <br />m <br />PERMIT CLASS OF WOfiK � <br />z <br />❑�UILDING �PLVMBIIVG [�MECIiANICAL �NEW ❑ADDITION ❑ALTEFATION ❑REP�IR ~ <br />� <br />� <br />VALUATION OF WORK w <br />5 ❑DEMOLISH ❑FENCE ❑$IGN ❑SWIMA�ING POOL a <br />OESCRI6F WORK A A <br />2D i�ii ?�-r rr.(-'? ,. �F 2 Y <br />PROPOSED USE MECHANICAL <br />LEGALDESCRIPTION OF PROPEFTV (SHOW BELOW OR ATTACH TVPE OF WEL nOIL ❑GAS ❑LPG. �ELEC. <br />FOUR COPIE51 <br />�oT BLOCK—OF NO. TVPE OF EQUIPMEN7 FEE <br />AIR COND. UNITS-H.P. EA. 5 I <br />REFRIGEFATION UNITS-H.P. EA. <br />BOILERS-H.P. EA. I <br />GAS FIRED A.C. UNITS-TONNAGE EA. <br />� FORCED AIR SYSTEMS-9.T.U. M EA. � I <br />JOB AD[�RE55 L,,� WALL HEATERS-B.T.V. M <br />�jL��if] '�%:€'�'�r'i �v1• — <br />UNIT HEATERS-D.T.U. M � <br />EVAPORATIVECOOLERS <br />PLUMBING CLOTHES DfiVERS I <br />VENTILATION FAN <br />RANGEHOOD I <br />NO. TVPE OF PIXTUPEOR ITEM FEE A�R FIANDLING VNIT- QF.M. <br />WATER CLOSET (TOILETI g INCINERATOF I <br />BATHTVB <br />iAVATORYIWASH8A51N1 � <br />SHOWER <br />KITCHEN SINK & DISP. SUB TOTAL 5 Lk I <br />DISHWASI/ER PERMIT <br />InUNDRY TRAV TOTAL FEE . I� <br />CLOTHES WASHER THIS PEFMIT BECOMES NULL AND VOIC �r y�pRK OR CONSTRUG <br />WATER HEATER TION AUTHORIZED IS NOT COMMENCED WITNIN 120 OAVS, OR IF <br />UpIN!\1. CONSTRUCTION OR WOPK IS SUSPENDED OR ABANDONED FOFi A <br />�DRINKING FOUNTAIN PERIOD OF 120 DAVS AT ANY TIME AFTER WOFK IS COMMENGED. <br />FLOOR-SINY. OR �RAIN I HEREBY CEftTIFY TNAT I HAVE READ ANO E%AMINEO THIS AP� <br />Vl1CUUh1 �REAKERS PLICATION AND KNOW TNE SAME TO BE TRVE AND CORRECT. ALL <br />ROOF DRAINS-RAINLEADERS WROVISIONS OF LAWS AND OR�INANCES GOVERNING THIS TYPE <br />OF WORK bVILL BE COh1PL1ED WITH WHETHER SPECIFIED HEREIN <br />SINK ISERVICE-�AF, ETC.) Ofi NO'f, THE GfiANTING OF A PEflM1T DOES NOT PflESUME TO <br />— GIVE i1UTHOfiITV TO VIOLATE OR CANCEL THE PROVISIONR OF <br />ANY OTHEFi STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE Of CONSTRUCTION. <br />SU�TOTAL <br />PERMIT S <br />TOTALFEE 5 <br />' X ;1��;� <br />SIGNATUREOFCONTfiACTOFORAUTH.AGENT DATE <br />SIDEVARDSETBACK STREET'3ETOACK REAFYAR�SE70ACKPLANCHECKNUMBER P�ANCHECKFEE <br />FEE RECEIPT NO. <br />USE ZONE LOT AREA VAGANT SITE <br />OvEs ❑No FEES VALUATION FEE <br />TVPE OF CONST. OCCUPANCV GROUP UNIOS OWELLING � <br />512E OF �LDG. NO.OF STORIES MAX.00C. LOAD BVILDING S I <br />I <br />PLUA101NG � <br />FIREZONE BASEMENT R 4VIREDKLERS � <br />❑YES ❑NO MEC�. �CAL <br />SPECI'AL CONOITIONR� OTHER � <br />I <br />PtNLLTV SEC.303�a) � <br />TOTAL ( � <br />PERMIT VALIDATION <br />WI1EN PFiOPEPLV VALI�ATED (IN THISSPACE) THIS IS VOUR PEHMIT <br />pPPLiCAT10NACCEPTEDBY: VLANSCIIECKED9Y: APYPOVEDFO�ISSUAC,N,EBY: <br />� <br />� <br />