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' ��� Ll''l��/�'!'lI I <br /> CI�V pF' � <br /> i CONSTRUCT'ION eaeretf} i <br /> � �verett PERMIT <br /> I LiSY NdLI 159PP,p� I <br /> �I fVE4E!i. V�.p11fILIUY. I <br /> 9i1�1 <br /> °"` °' `°""°'"" gUILDING MECHANICAL PLUMBING � <br /> �.�E�o�..,F�� <br /> � ��"��EA MAILADOHEb:; LIV Y���'.':[ I <br /> �.. i"�. :S(St(:.�. Y 1.:�y LJj��`. . -..�'? I <br /> IAflCiPT[CT OR DESIGNER IdAIL ADDRE55 PHONE L�CENSE NO. <br /> I I <br /> GENEAALCONTRACTOR MAIL ADDPE55 PHONE LICENSE NO. I <br /> � L''�ar.}tt �i1l3crs Sb:S ivor.c;zear. ,7xy� :53•-71G2 223-^1-"t,"-�'Tt-�r'. ::;1:':- <br /> � <br /> MECHANICALCONTRACTOR MAILADDPESS PHONE LICENSENO. I <br /> VVJMBINGCONTRACTOR MAILADORESS PHONE LICENSENO. � I <br /> � � I� PERMIT m <br /> CLASS OF WORK � i <br /> � <br /> �6UILDING �PLUMBING 7 MECHANICAL �{ Z � <br /> ❑NEW ❑ApDITIpN �JALTEqATION ❑HEPAIp ~ I <br /> VALVATIONqOF WORK � � <br /> � P�iCI�•I)Q ❑OEIdOLISH ❑FLNCE ❑SIGN ❑SWIMM�NG POOL W I <br /> pE5CF18[WOFK - - a <br /> rC'".''i'':� �"�r�:': _ �•�t.r .�.'�✓ ' ,'7�?�.:t " ;i:C':'' ��1 V <br /> I anoNosEo use J <br /> MECHANICAL <br /> � ��cn�ooscnirrioNorr•r�o�er�-n� ,iio�miaei.uwoNc.rrn-�i Tvr�eorFuei=�oi� �-�N�r --�u��:. �ei.er.. <br /> i <br /> i Fouci��iF� �'�a :;i�.w•`�71 ].$t, p1c�C;. �i: NO. TVPEOFE�UIPMEN7 __ <br /> 3 FEE <br /> LOT BLOCK_OF__ <br /> L�VOrL�Lt — AIR COND. UNITS-Y.P. EA. 5 � I <br /> REFRIGERATION UN�TS-H.R EA. <br /> / 1 ^�f F�OIIEFS-H.P. FA. � <br /> T7J��)D7":/GS9�OO�I GHS FIqED 4.C. UNITS-TONNAGE EA. I <br /> I .____ FOFCED AIR SVSTEMS-�.T.U. M EA. � I <br /> JOB r1flES3 WALL HEATEqS-B.T.U. Id <br /> �':��, !:n rL , <br />� I VNI? HEATERS--�.'..l'. M � I <br /> PLUMBING • EVAPORATIVECOOLERS <br /> � —•CLOTHES �PVERS � I <br /> I VENTILA'fIONFAN -T— I <br /> I _ RANGE HOOD � <br /> N . TVPE OF FIX7URE OR ITEM p, E � AIF HANDLING VNIT- C.F.M. i <br /> I N'�+TEfl CLOSET(TOILET) ; , - INdNEfiATOq � I <br /> .�ATIITUO n � <br /> � _ LAVnTORY IwnSH BASINI � � <br /> � SHOWER -- i <br /> i KITCMENSINKWDISP. SUBTOTAL 5 � <br /> DISHWASHER � <br /> �, LA�.JDflY TFiAV '�--' PERMIT $ ' <br /> CLOTHGS WASHEq TOTAL FEE 5 � <br /> � N_nTEH HEATER } TMIS PERMIT DEl'OMES NULL nND VGID IF WpRK Ofi CONSTRUC� I <br /> - TION AUTHORI2ED IS NOT COAIMENCEO N1ITHIN tt0 DAYS. OR IF <br /> URINAL CONSTFlUCTION OR WORK IS SUSP[N�ED Oii A�ANOONED Fpq n � <br /> _ ORINKING POUNTAIN �'ERIOD OF 720 D4Y5 AT ANY TIME AFTER WOfiK I$COMMENCED. <br /> FLOOH-SINK OR DfiAIN I HEFEBY CERTIFV THAT I HAVE REAO AND E%AMINEO THIS AP- <br /> VACUUM BREAKE115 PLICl1T�ON AND KI,IOW THE SAME TO dE TRUE ANC COFlpECT. A�L <br /> ROOF ORAINS-RlUVLEADERS --I--- P�OVISIONS OF LAWS AND OROINI�NCES GOVERNING iN1$ TYPE <br /> —� OF WORK WILI. Oe COMPLIED WITIi WHETHER SPECI�IED HEREIN <br /> SIIVK ISERVICE-�BAR,E:C.) OR NOT, THF. GRANTING OF A PEftA1lT DO[S NOT PRESUME TO � <br /> __ �— GIVE AUTHOFITv TO VIOLAfE OR CANCEL THE PROVISIONS OF I <br /> ANY OTHER STATE OP LOCAL LnW REGULATING CONSTflUCTiON I <br /> -- OR TME PL(iFppMANCE OF CONSTRUCTION. I <br /> SUB TOTAL <br /> PEHM�T 5 <br /> I TOTAL FEE $ �J1�/^� <br /> X � . <br /> SIGNATURE OF CONTltACT0l1 Oq nUTH.AGENT DATE <br /> SIOE v�RD5ET0ACK SIREEf SET6ACK REAR�Aqp5ET6ACK PI.AN CHECK NUMREH PLANCHECK FEE I <br /> I �FEE RECEIPTNO. <br /> . USE ZONE �OT AREA VACANTSITE <br /> i ❑vEs ❑rvo FEES VAWATION FEE I <br /> I TVPEOFCONST. OCCUPANCYGROUP NO.OF�WELLING - <br /> UNITS <br /> I <br /> I SI2E OF OLDG. NO.OF STORIES MAX.OCC. LOAD L'UILDING $ i'I � ` • � � " � r � <br /> I <br /> � <br /> PWMBItJG n I rI. I <br /> i HFEZONE �ASEMENT FIqESPfiINY,LERS <br /> RI-QUIRED <br /> ', ❑VES ❑NO MECHANICAL � I <br /> i SPECIALCONOITIONS: OTMER I <br /> � _ 1 � ) <br /> . — -- PEN6LtY $EC.807(ui I <br /> � rora� 33i 'iJ <br /> I PERMIT VALIDATION <br /> WHf N VROPLftLY VAI IDATED (IPl THISSPACEI THI515 YpUR�'E(iAtIT I <br /> I I <br /> � <br /> � <br /> nvpIICLT�ONALClPTE06V PLANSCXFCNEOIv �qavuOVfOlOni�^.i.�q;�fOv <br /> I <br /> I ' <br /> I iI <br /> � <br />