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' .hr c:�,vyn�,�n � � <br /> ��,� �� CONS'fl�UCTION everelt <br /> � e�erett PERMIT �� <br /> I' �:�,..�>�: ; <br /> b.F::ll 'IA'.��'!nd(P: I <br /> � 3i:.11 <br /> "" " `°"°•;" gUILDING MECHANICAL PLUMBING <br /> �E�r�aP„E,;r , <br /> owNeR ma� nooaess zi❑ r��on:e ! <br /> _.,._._i.:, ,..._�_., .< ��}� -. , (� ` ��� i <br /> AJLY I. . �_�J���V . . <br /> ARCHITECTONDESIGNEF A�qILA�DRE55 PHONE LICLt:SLNo '' <br /> � GENEPALCONTRqCTOR MAILADDPESS PMONE LICENSEtvO. I <br /> � r,.,. ...t, -:�;-,3� I <br /> MECMANICALCONTRACTOR MAIL ADDRESS PHONE LICENSE NO. I <br /> PLUMDING CONTpACTOR MAIL ADDRESS PHONE LICENSENO. � � <br /> I W <br /> m <br /> PEqMIT CLASS OF WORK � <br /> � � <br /> T <br /> �BUILDING ❑PLUM6ING ❑�AECHANICAL F <br /> ❑NEW ❑AUDITION ❑ALTERATIpN �REPAIF � <br /> VALUATION OF WORK — <br /> �0I poeMoi �s�� ❑r�r;ce Osicrv ❑swi�nr,�iur. r•oo� w � <br /> 5 _ a I <br /> DESCFIB[WOHK -- —/{ ]^ I <br /> ^ �J •�� ' - • • ` 1 ` I <br /> PftOPOSEC USE <br /> 19ECHANICAL <br /> LEGALOESCRIPiIONOFPHOPEiiTY �5HOW8ELOWpRATTACH i'ihi.�(�I- 1`UEL �OIL �NnS. ��LPG. �EL[C I <br /> . FOUfi COPIESI �f�s I <br /> � �o7_.i��i�oCK�.s�oF � �� ri�� I} ND. 7VPEOFE�UIPMENT FEE <br /> Alfl CONO. UNITS-H.P. EA. 5 I <br /> REFRIGERATION UNITS-�H.P. EA. <br /> OOILE�S-H.P. EA. � <br /> Gq5 PIPED A.C.UNITS-TONNAGE EA. <br /> ,____ FORCED AIq SVSTEMS-B.T.U. M EA. � <br /> JOH nDDqE::S � WqLL HEATERS-D.T.U. M <br /> UNIT HEATERS-B.T.U. M � <br /> EVAPORATIVECOOLERS <br /> PLUMBING c�ornesoaveRs � <br /> VENTII_ATION FAN <br /> FANGEHOOD � <br /> NO. TVPE OF FIXTURE OR ITEM FEE Alq HANDLING UNIT- C.F.M. <br /> WATERCLOSET(TOILiTI g � �NCINEFATOR � <br /> OATHTUO <br /> _ �AVATORY�WASH6ASIN) � � <br /> SHUWEfI <br /> KITCH�:NSINKB� DISP. � $U�TO'iAL 5 � <br /> OISHWl.SHER <br /> LHUNDFY TiiAY PERMIT <br /> CLOTHESWASMER TOTALFEE 5 � <br /> WAT[R MEATER 1 TNIS PERMIT BECOMES NULL ANO VOID IF WORK Ofl CONSTRUC- I <br /> iION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAVS, OR IF <br /> URINAL ; CnNSTRUCTION OR N'OflK IS SUSPENDED OR AOANDOh'E� FOF A I <br /> DRINKING FOUNTAIN � - PE,:IOO OF 120 �AYS AT ANV TIME AfTER WOflK IS COMMENCED. <br /> FLOOp-SINK GR OflAIN I IIEREBY CERTIFV TMAT I HAVE fiEAD AND E%AMINED THIS AP I <br /> VACUU1n BFEAKEiiS PLICFTION AND KNOW iME SAME TO OE TRVE ANO CORRECi�. ALL <br /> flOOF DRAINS-RAINLEAOEPS �— PAOVI;IONS OF �AWS AND ORDINANCES GOVERNING THIS TVPE <br /> � _ OP N'OHK WILL BE COMPLIED WITII WHETHER SPECIFIED HEREIN <br /> SINK (SEFVICE-flAP. ETC.) _ OR NCi, THE 9qANTIfvG OF A PERM1".IT ppES NOT PRESUME TO <br /> i GIVE AUTNOFITV TO VIOLATE OR Cl�NCEL THE PROVISIONS CF <br /> ANV OTH[P STATE Ofl LOCAL LAW REGULATING CONSTRUCTION <br /> - _ OR LHE PERFORMANCE OF CONSTRVCTION. <br /> SUBTOTAL <br /> ' PERMIT 5 <br /> ' TOTALFEE 5 <br /> �' ?.3,/I7�76 <br /> , SIGNATUREOFCOMRACTORORAUTH.AGENT DATE <br /> SIOEVARUSETBACK STFEETS@TBACK qEAR\'AflOSETAACKPLANCHECKtVUA1FiER I PLl�NCHECKFEE <br /> FEE FECEIPT NO. <br /> USE 20NE LOT AFEA VACANT SITE —�� <br /> � ❑vEs ❑No FEEg I VALUATION FEE I <br /> TYPE OF CONST. OCCUPANCV GROUP NO.OF OWELLING T— I <br /> UNITS � <br /> SIZE OF [3LOG. NO.OF STORIES MAX.00C. LOAD [iUILDIIJG . 5 T� P,��fb1 I <br /> qnL W <br /> I <br /> PWMBING � <br /> FIqEZONE OASi�p.1ENT q�EOUIRE�OKLERS � <br /> ❑YES ❑n:p MECHANICAL � ' <br /> I i <br /> ' � i <br /> SPCCIALCONDITIONS: OTHER <br /> — I <br /> _T.--' <br /> PENELTY SEC.90'31a1 I i <br /> 1 <br /> 70TAL L1_�� I <br /> �� i <br /> PERMIT VALIDATION I <br /> --�- - WMBN PROPERLV VALIDATED (IN THISSPACEI iH1515 YOUR PERM1IIT � <br /> d I <br />�' nCPL�rnt�oNAcc[riloUv >tANSCII¢KEI]nr nPVPOVEDi0RI55UNlt[ n• I <br /> 1w 0. � <br /> i <br /> � I <br /> , <br /> � <br /> I <br /> _ ,, r <br /> A � <br />