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rhe Eve�yrcen <br />��rv �� <br />evereit <br />��„ �,.,,, ;:���.. <br />EVkFlIf. �iM.�l.i�l�tl�`� <br />�?.'�I <br />otrr acGo"vu•.�rv <br />owuornm:r <br />BUILDING <br />CONSTRUCTION <br />PERMlT <br />MECHANICAL PL.UMBING <br />everett <br />OWMEF ,�n M1IAILAODR[SS ZIF f�HONE y� <br />���f����.�� ,. i.:.l'J ....�.. �.f''�1: <br />ARCHITECT OR �ESIGNER MAIL ADDflESS i'HONE LICENSE NO. <br />GENEflALCONTRACTOF MAILADDRE55 PMONE LICENSENO. <br />3!'ti�Y_,S �-i..Y..r 7(X�2UL1 <br />MECMANICALCONTRACTOR MAILADDRESS PHONE LICENSENO. <br />PLUMBINGCONTRACTOR MAILAODRESS PHONE LICENSENO. � <br />W <br />G1 <br />P[RMIT CLASSOF WOflK � <br />z <br />�pUILDING [jPLVM6ING ❑MECHANICAL F- <br />❑NEW ❑AO�ITION ❑ALTERATION ❑PEPAIP � <br />VALUATION� F W(�yqy K � <br />5 NT./�'+�/ �DEMOL611 ❑FENCE ❑SItiN ❑SWIMM11�P1G FOOI a <br />�ESCRIBE WORK � <br />., -s�L��:� : �:zu► �,.�c 19f $ <br />a�oroseo use MECHANICAL <br />LEGALOESCflIPTIONOFPROPERTV�SHOWf1ELOWORATTACH iYPEOFFUEL �OIL �Gn;L �LPG. �ELEC. <br />I'OURC PIESI <br />�oT � BLOCK�oF�f '��� NO. TVPE OF EaUIFMEN7 FEE <br />AIR COND. UNITS-H.P. EA. 5 I <br />� REFPIGEF�ITION UNITS-N.P. EA. <br />BOILEflS-H.P. EA. � <br />GAS FIRED A.C. UNITS-TONNAGE EA. <br />FOFCE� AIR S�STEMS�-B.T.U. M EA. I <br />JOB ADUR[55 q�y.� WqLL HEATERS-�.T.U. M <br />GCIt+ t��i� UNITHEATERS-9.T.U. M I <br />[VAPORATIVECOOLERS <br />PLUMBING c�orr�es onv�ns i <br />VENTILATION FAN <br />RANGEHOO� 1 <br />AIR HANDLING UNIT- QF.M. <br />NO. 7VPE OF FIXTURE OR ITEM FtE <br />W4TEFCLOSET(TOILFT) g INCINEFATOR � <br />DATFITUB <br />__�� <br />LAVATORY (WASH BASIN) I <br />SHOWER �— <br />KITGHEtv SINK & DISP. SVD TOTAL 5 � <br />OISHWASIIEF _ PERMIT S--T <br />LAUNDflYTRAY <br />— TOTAL r-EE 5 � <br />CLOTHES WASHEF THIS PERMI7 pECQMES NULL AND VOID IF WpqK OR CONSTqUG� <br />WMEfl HEATER � TION AUTNORI2ED IS NOT COMMENCEO WITHIN 120 DAVS, OR IF <br />URINI�L CONSTRUCTIGN OP NlOflK IS SUSPENDED OR A[IANDONED FOR A <br />D(iINKING FOUNTAIN PEHIOD OF i20 DAYS M' I�NV TIME AFTER WOfiK IS COMMENCEU. <br />f-LOOR�-SINK OR ORAIN I HEREBY CEflTIFV THAT I HAVE READ ANO EXI�MINED TNIS AP- <br />Vl�CUUM �REAKEHS PLICATICY AND KNOW THE SAME TO f1E TRUE AND CORFECT. ALL <br />PROV!SIONS OF LAWS AND ORDIN/:NCES GOVERNIfJG THIS TYPE <br />FOOF DRAINS-flA1NLEADERS pF WGRK WILL 6E COMPI.IFD WITH W;'ETHER SPECIFIED MEREIN <br />SINK (SERVICE-UAR, ETC.) O!i NOT, THE GRANTING OF A PEFiMIT DOES NOT PRESUIdE TO <br />GIVE AI�THORITY TQ VIOLATE OR CANCEL THE PRUVISIONS OF <br />ANY UTI�EF STATE OR LOCAL LAW REGULl�TING CONSTRUCTION <br />OR TIIE VE�iFOFlMnNCE OF GONSiPUCTION. <br />SUBTOTAL _ � <br />PERMIT S <br />TDTALFEE S <br />x <br />SIGNATUREOF(;pNTR�CTORORAUTH.AGENT OATE <br />SIOE YAqD SLT�l1CK STREET SET�ACY, REAR VARDSETBACK PLAY CHECK NUA11tER PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USEZONE LOTAPEA VAC/�NTSITE <br />❑vEs �No f-EES VALUATION FEE <br />l'VVE OF CUNST. OCCUPANCY GROUP NO.OF OWELLING <br />V N 115 I <br />SIZE OF BL�G. NO. OF $TORIES MF%.00G LOAD DUILOING 5 i� Aw�l�'1 <br />LiY� W <br />PLUM�ING � <br />FIfiG 20NE �ASEMENT 1°IqESPflINKLERS � <br />Ff�UIREC� I <br />❑'/ES ❑NO M@CHANICAL � <br />1 <br />SPECIAL CONDITIONS: _ _ OTHER � <br />PENELTV $EC.307101 1 <br />TOTAL � <br />�� � <br />PERMIT VALIDATION <br />lVH[N VqOP[RLV VALIDAfED 114 THISSPACEI THIS IS YOUR P[RNII <br />nv��if.A*iUNnCCEPiFOflY. vLANSCUTKF�oY� n�alipvfDFOFi55UntiCl lrv <br />� C� <br />�� .. <br />