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�� dir Ereryrceii �'I <br /> ��TYo� CONSTRUCT10�1 eve� eYt �i <br /> everett PERMiT ' <br /> �,,. ,.,�� ,53�,�5 I <br /> [A'ER[II '.:>Y�41;�pi � <br /> ��P� ��«�°�:°:°�°�,' BUILD{!VG MECHANICAL PLUMBING '� <br /> �EVE�oF„�:r <br /> OWNER MAILt�ODRESS Z�v NHONE i <br /> I �:iA�� g.RT�";: 'i '�'07 %%:":cr' 23:?�'7G <br /> ARCHITECT OF DESIGNER MAIL ADDPE55 �'HUNE LICEhSE NO. � <br /> � <br /> GENEFAL CONTRACTOR MAIL ADDFESS PHONE LICENSE NO. <br /> MECHANICALCONTRACTOR MAIL ADDRE55 PHONE LICENSE NO. <br /> � <br /> PLUM�BIeNG CONTRACTOfl MA1L ADORESS PMONE LICENSE NO. W <br /> .S`�a.� m <br /> � <br /> PEHMIT CLA55 OF WORK z <br /> ❑ 6UIlDING �PLUM�ING ❑M@CHANICAL ~ <br /> ❑NEW ❑��D�ITION ❑ALTERATION �F[PAIH � <br /> � <br /> Vl�LUATION OP WORK W I <br /> ❑OFMO�ISH ❑FENCE ❑SIGN ❑SWIMMING POOL a <br /> DESCRIBE WOPK r...y}���.�. /,_+• ^ :i�'? — — 'I Q� <br /> 1 V <br /> PROPOSE� USE MECHANICAL <br /> ivPE oP FUFL �OIL nGnT. �LPG. �ELEC. <br /> L[GAL D'eSCRIPTIOh OF PqOP[RTY (SHOW �ELOW OH �T i n(:�1 <br /> POUF COPIE51 <br /> NO. l'/PE OF E�UIPMEN7 FEE <br /> LOT BLOCK_OF AIR COND. UNITS-H.P. EA. S � <br /> flEFRIGERnTION UNITS�-H.P. EA. <br /> OOILERS-M.P. EA. � <br /> GAS FIRED A.C. �1NIT5-TONNAGE EA. <br /> FORCED AIR SVSTER!5-B.T.U. M EA. � <br /> J06 A,DRESS AfM "�_'�'�^� WALL HEATERS_B.T.U. M <br /> F.ul/ + I <br /> UNIT MEATEPS-B.T.U. M <br /> [V��'ORATIVE COOLER£ <br /> PLUMBING ~c�orHes oaveas � <br /> VENTILATION FAN <br /> . RANGEHODD � <br /> I AIR HANDLING UNIT- C.F.M. <br /> NO. IYPE OF FIX7URE OR ITEM FEE �nCINERATOR � <br /> li WATERCLOSETITOILETI _ S <br /> �i, BATHTU[3 -- � <br /> �� L4VATORV IVJ�iH 9ASIM — <br /> � Sh1UWLH —_- " _ — " <br /> �' KITCHEN SINK �, DISP. SUB TOTAL 5 I <br /> � OISHWASHER PERMIT 5 <br /> LAUNOR� TRA1' _ TOTALFEE S I <br /> i CLOTHES WASHER THIS PERMIT BECOMES NULL ANO VOID IF ' lORK OR CONSTRUG <br /> I Wl�TEF HEAIEF TION AVTHORIZED IS NOT COMMENCED Wll H1N 140 �AVS, OR IF <br /> URINnL CONSTRUCTION OR WORK IS SUSPENDED OP ABANDONEO FOR A <br /> PERIOD OF 120 D��S AT AN� TIML l�FTER WORK IS COMMENCED. <br /> DRINKING FOUNTAIN <br /> fLOOF- SINK OR DRAIN I HERE6Y CEflTIFY THAT I HAVE READ AND EXAMINFD THIS !�V- <br /> PLICAT�ON AN� KNOW THE SAME TO�E TRUE AND CORRECT. ALL <br /> VACVUM F3REAKERS — PROVISIONS OF LAWS AND OROINANCES GOVEHNING THIS TVPE <br /> qOOF ORAINS-RAINLEAOERS -{ OF WORK WILL BE CCMPLIED WITH WHETHER SPECIFIE� HEREIN I <br /> II SIN (SERV [-OI�R, ETC.) f OR NOT, THE GFANTING OF A PEftM1T DOES NOT FIiESUME Tt� <br /> 1 GIVE AUTMOFITY TO VIOLATE OF Cl�NLEL THE PROVISIONS OF I <br /> ANY OTHER STATE OR LOCAL LAW REGULATIM1G CONSTFUCTION <br /> �� _— OR THE PERFORh1ANCE OF CONSTRUCTION. <br /> SUBTOTAL _*'�� � <br /> PERN�IT $ J "Ju <br /> TOTAL FEE 5 _ _ J j� _ h/Y�� <br /> x "� <br /> SIGNATUFEOFCUNTRACTORORAUTH.AGENT Dl1TE <br /> ;IDE YARD SET�ACK STREET SET�ACK REAR YAiiOSET�ACK PLAN CHECK NUM6ER PLAN CMECK FEE <br /> FEE RECEIPT NO. <br /> USE 20NE LOT AREA VACANT SITE <br /> , ❑YES ONo FEES VALUATION FEE <br /> � TVv[pF CONST. OCCUPANCV GFOUP UN'OS DWEI.UNG � <br /> I _ 1—_'_ <br /> i SIZE OF BIDG. NO.OF STORIES MA%.OCC. LOAD OUILDING 5 I <br /> PI_UMOING � � <br /> � BASEMENT qEpUIFE�DKIEfiti � — <br /> FIqE ZONE <br /> � ❑YES ❑NO ��ECHANICAL � _ <br /> I <br /> � I <br /> I SPECII�LCONOIT10N5'. JTHER I <br /> II _ V[�uELT\�— SEC.3091e) � _ I <br /> 1 <br /> — TOTAL t � �I <br /> -- PERMIT VALIDATION I <br /> WHEN VROPERI_V VALI�ATEO �IN THISSPAC[I THI515 YOUR PLfiI.11T <br /> I — <br /> I <br /> r,P���itn12n1qOGGPi[Ulrv nlANSf:NECY,COBM'. P�PIIOVI�f�C�Unhf,FPv �I <br /> 1! u� �M Y <br />