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i <br /> �hc Evcrgrecn � <br /> �,TYOF CONSTRUCTION everefit � <br /> �verett PERMIT <br /> L�iY ridLl 159¢S56 <br /> E VE Ff Li.1Y451f.!�L149 <br /> 9i]91 <br /> �Eo� �F=����������r BUILDING MECHANICAL PLUMBING <br /> ocvcioaMEr�� <br /> OWNER MAILADDPE55 Zlf� �'MONE <br /> '3'� :1::5:►3fi�-iT� �^3.�jt1� ��^--77 <br /> ARCHITECT OR DESIGNER <br /> MAIL ADD(iE55 PHONE LICENSE NO. <br /> GENERALCONTRACTOR <br /> MAIL AODRE55 PHONE LICENSE NO. <br /> J-r�'� PHONE LICENSE NO. <br /> MECHANICALCONTFACTOR MAILADDRESS <br /> � <br /> MAIL ADDRESS PHONE LICENSE NO. W <br /> PLUMOINGCONTRACTOR n] <br /> � <br /> PERMIT CL/155 OF WORK z <br /> r <br /> [�UILDING ❑ PLVMBING ❑tdCC11ANICAL �NE�.V ❑ADDITION ❑nLTERATIJN �REPAIR � <br /> � <br /> VALUATION OF WORI: w <br /> 5 �M,� ❑OEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL a <br /> "�J �] Q <br /> DESCFI6E WOFK (,��3 Q <br /> ;�r�¢gr (� ; ') <br /> PROPOSED USE MECHANICAL <br /> TVPFOFFUEL �UIL �Gns. ❑LPG. �ELEC. <br /> LEGAL OESCftIPTION OF PROPERTV (SHOW 6ELOW OR ATTACH FEE <br /> FOUgCQPIE51 .,`,`�,. Np, 7YPEOFEQUIPMENT <br /> �p7 '��� BLOCK—aF <br /> 'r' -��"' '� qlq COND. UY.ITS-H.R EA. 5 I <br /> fiEFRIGERATIDN UNITS-Ii.P. EA. <br /> BOILERS-H.R EA. � <br /> GAS FIREO A.Q UNITS-TONNAGE EA. <br /> FORCEO AIF SYSTEMS-d.T.U. M EA. � <br /> WALL HEATERS-B.T.U. M <br /> JOBADJflESS — � <br /> � � ��I .:� UNIT HEATERS-O.T.U. M <br /> EVAPORATIVECOOLEftS <br /> PLUMBING CLOTHESOR�EFS � <br /> VENTILATION FAN <br /> RANGEHOOD � <br /> AIR HAN�LING UMT- C.F.M. <br /> NO. T'PE OF FIXTURE OR ITEM FEE INCINEPATOR � <br /> WATER CLOSETITOILETI 5 '1 <br /> ' BATHTU� � <br /> i LAVATORV(WASH BASINI <br /> SHOVlEft SUBTOTAL 5 I <br /> KITCFIEN SINK& DISP. ( <br /> I DISHWASHER PERMIT 5 � <br /> I _ LAUNDRVT(iAY TOTAIFEE 5 I <br /> CLOTNES WASHER THIS PERMIT HECUMES NULL AND VOID IF WORK O!i CONSTRUC- <br /> � WATEfl HEATER TION AUTHORI2ED IS NOT COMMENCEO 'NITNIN 120 DAYS, OR IF <br /> i CONSTRUCTION OR N10RK �5 SUSPENDEO OR ABANOONED FOR A <br /> URINAL PEfiIOD OF 120 DAVS !�T ANV TIME AFTER WORK IS COMMENCED. <br /> DRINKING FOUNTAIN I HEREBV CERTIFV THAT I HAVE READ AN� E%AMINED TNIS AP- <br /> FLOOR-SINK OR DRAIN PLICATION AN� KNOW THE SAME TO BE TRUE AND CORREGT. ALL <br /> VACUUM [iREAKERS PfiOVI510NS OF lAWS AND Of1DINANCES GOVEPNING TIi15 TYPE <br /> ROOF DHAINS-RAINLEAOERS OF WORK W�LL 6E COMPLIE�WITH WHETHER SPECIFIEO HEREIN <br /> SINK ISERVICE-BAR.ETC.1 OF NOT, THE GFANTING OF A PEPMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITV TO VIOLATE OR CANCEL TME PftOVISIONS OF <br /> ANV OTHER STATE OR LOCAL 1.AW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONS"i HUCTION. <br /> SUB TOTFL <br /> PERMIT 5 <br /> TOTALFEE 5 <br /> x Ll'Ll i <br /> SIGNATVFEOFCONTRACTOPORAUTN.AGENT DATE I <br /> PLAN CHECK FEE <br /> SIDEVAFOSETDACK STREETSETUACK REAR1'AFDSET6ACKPLl�NCHECKNUMBEfl FEE RECEIPTNO. <br /> USE 20NE LOT AREA VACANT SITE <br /> �� ❑yES ❑NO FEES VALUATION FEE <br /> I T�PE OF CONST. OCCUPANCY GROUP NO.Of DWELLING I <br /> UNITS <br /> �q�� I � <br /> SI2E OF 6LDG. NO.OF STORIES MAX.000. LOAD BUILOING 5 �n���) <br /> I <br /> PLUMBING I <br /> FIFEZONE �ASEMENT FIRESPRINKLERS I <br /> Rf�VIRED MECHANILAL � <br /> ❑VES ❑NO <br /> I <br /> SPECIFL CON�ITIONS: OTHER � <br /> PENELTY <br /> SEC.9031a1 � <br /> — I <br /> TOTAL � � <br /> PERMIT VALIDATION <br /> WH[N P(iOPERLY VALIDATED IIN THIS SPACE)l HIS IS VOUR P@RMIT <br /> ♦ I <br /> piwLICATIONACCEPTED9V: CLANSCNCCRED�Y'. <br /> APPflOVCO FOI!65VP1iCC OV I <br /> ?• �.• <br /> n <br /> I <br /> ` <br />