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ithc Evcrg�ren <br /> ��,� �F Cf�(��T�?lI�T��11V everett <br /> �veTet� PERMi"G <br /> ���,,,.,,� ,:vzEz, <br /> �;��«r ,..::�,���,���: <br /> 9A]�I <br /> ""' "` `°•'':""" BUILDING MECHANICAL PLUMBING <br /> �reE�u,��nn <br /> OWN[fl 1dA1L ADORE55 Z�V PryONE <br /> .'�� <br /> ARCHITECTORDESIGNEF MAILADDRE`.5 PHONE �ICENSENO. <br /> � - ^'J <br /> GEM1ERAL CONTflACTOft MAIL A�DFE55 PHONE LICENSE NO. � � <br /> .e .L:2�:.j► <br /> MECHANICAL CONTqACTOR MAIL AODRE55 PHONE LICENSE NO. <br /> � �PLUMBING CONTflACTnR MAI�ADURE55 PHONE �ICENSE NO. W <br /> m <br /> VERMIT CLASS OF WORK � <br /> � „�v' z <br /> - u6UILDING ❑PLUMBIN^. �MECNANICAL YR F <br /> ❑NEW ❑ADDITION ❑ALTEF�ITION �JfiEFnlli � <br /> Vt.LU/p�(�'q�Oqry O/�F WORK � <br /> �!fiM'++3 ❑�GMOLI51� ❑ftNC[ ❑SiGN ❑G\VIMMING POOL � � <br /> OESCRI�C WOFn <br /> Ar'u�?. :-.--;� 2�98 <br /> FfiOPOSED USE <br /> MECHANIGIL <br /> ivr�EorFuei. �oi� �Nnr—r]�vc. �E�ec. <br /> L[GAL DEiCRIVTION OF PflOPERTV ISMOW dELOW ON ATiACH G�15 <br /> FOUfi� 1 <br /> Lor � �'�LOCK�oF ���,'1 "^dV� �1 _ NO. TYPEOFEQUIPMENT FEE <br /> AIR COND. UNITS-H.P. EA. 5 I <br /> FIEFFIGERqTIpN UNITS-H.P. EA. � <br /> — f301LEF5--H.P. EA � <br /> GAS FIfiED A.C.UNITS-TONNAGE E�1. <br /> _ FORCEO AIR SVSTEb15-�.T.U. M EA. I <br /> J06 ADDItCiS �� r��.�p.� WALL HEHTERS-B.T.U. M <br /> G" SY <br /> UNIT HEATERS-A.T.U. M I <br /> PLUMBING evnNoanrivEcoo�eas <br /> CLOTHflSGFVERS � <br /> V�iNTI1.AT10N FAN <br /> _ FnNGEHOOD I I <br /> NO. TYPE OF FIX�URE OR ITEM FEE _ A�A MANOLING UNIT- C.f-.M. <br /> WATER CLOSET�TOILETI 5 �NCINEPATOR � <br /> 6AiHTUO <br /> _ LIIVATOFY (WASHBASIN) —� � <br /> 5!tCJ�cfl � <br /> KITCIfEN SINK& [l15P. SU�TOTAL 5 � <br /> DISNWASHEF — <br /> PEFMIT 5 <br /> LAUNDRY TfiAY — <br /> CLOTHES WASHER TOTALFEE � <br /> - THIS aERldlT pECOMES NULL ANp VOID IF WORK On CONSTBUC- <br /> WATER MEATER TION nUTHOf112[D IS NOT COM1IMENCEO WITMIN 120 DAVS, OR IF <br /> URINAL CONSTRUCTION OR WORK IS SVSPENDED OP AI3ANDONEO FOR A <br /> UFINKING FOUNTAIN PEPIO� OF 12� DAVS AT ANV TIME PFTER WORK iS COMMENCED. <br /> FLOOR-SINK Oq DRAIN I HERE6V CERTIFV TMAT I HAVE READ ANO EXAMWED THIS AP� <br /> VACUUM OREAKEFS PLICATION AND KNOW THE SAME TO pE TRUE AND CORRECT. ALL <br /> FOOP pRAINS-liAIWLEqDERS PROVISIONS OF LAWS AND OIiDINANCES GOVEPNING THIS TYPE <br /> OP WORK WILL (iE COMPLIEO WITH WHETHER SPECIFIED HEFiEIN <br /> $INk (SERVICE-f3AR,ETC.1 OR NOT, l"HE GRANTING OF A PER�IIT OOES NOT PRESUME TO <br /> GIVE AUTHURITY t0 VIOLAT[ OR CANC[L TH[ PROVISIONS Of <br /> �1NV OTIIER STME OR LOCAL LAbV REGULnTING CONSTRUCTION <br /> OR T•�E PERf-ORM1tANC[OF CONSfRUCTION. <br /> SUBTOTAL <br /> PEFMIT 5 --� <br /> TOTAL FEE 5 ��r i� <br /> X <br /> � ;I(iNATI:IiEOFCONT(iAGIDRORAUTH./aGENT DAT[ <br /> � SIDEVl�RDSETfiACK 57RFETSETf3ACK qEAHYARDSET6nCKPLANCHECKNUM6ER PLANCHECY. FEE <br /> j FEE RECE:?T NO. <br /> � USL ZON[ LOT AREA VACANTSITE <br /> � ❑vEs ❑No FEES VALUATiON FEE <br /> ! TYPE OF CONST. OCCUPANCV GRDUP NO.OF pWELLING <br /> UNITS � <br /> . r__--___— U'%WQ.� �+11 � <br /> ' !iIZE OF (3LDG. ND� OF STORIES MA%.00C. LOAD 9UILDING 5 <br /> i <br /> I PLUMBING � I <br /> '� fIflEZOf�E pA5[MEN1 FIRESPflINKLER; <br /> I ftfQUIRED � <br /> I ❑VES ❑NO MECNANICAL � <br /> i SPECIALCONOITIONS: — pTHER � <br /> I <br /> i - — PENELTv SEC.�031a1 I <br /> � � TOTAL ��� <br /> IPERMIT VALIDATION <br /> - WH[N PROPLRLV VALIpATED IIN TMIS SPACE)TH151$VOUR PEFMIT <br /> APPLIC�TtONACCFPi[OIIV� PLANSCHECKEOBY'. AFP�OVEDfOflI55UANf.LNY. <br /> i � �f <br /> I :? <br />