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� fhc Evcrurocn <br /> _��� �� CONSTRLlCTION everett <br /> � eveMrett PERMIT <br /> iE,�,:��� :.:,s„�.�,�,, <br /> 992J1 <br /> °E°' °' �°'°�°'°" gUILDING MECHANICAL PLUh1BiNG <br /> ���<<o�„���� <br /> OWNEq MAIL ADOFE55 LIP P!10NE <br /> ��:'� : �.:�w t���' <br /> ARCHITECT OR D' 31GNER MAIL AOfJfiE55 PHONE LICENSE NO. ,.�Y'r`�'� <br /> GENERAL GONTRACTOR MAII.ADDfiE55 PHONE LICEN'_'E NO. <br /> iLG ;'..xS.* ':t�7tlS�bL ���3 '.1��'1�-1�1.T'3�'•�''!22 �C <br /> MFCHANICAICONTRACTOR MAIL AD�RESS PHONE IICF!+SE NO. <br /> PLUMbING CONTFACTOR MAIL AODFE55 PHONE LICENSE NO. � I � <br /> W <br /> m <br /> PEFMIT CLASS OF WORK � <br /> z <br /> ��UILDIIvG � PLI.tdBING �MECHANICAL F <br /> ❑NEW �ADDITI'JN ❑ALTERATIDN ❑REP.?IR � <br /> VALUATION OF WORK � <br /> 5 .,l,r Q,� ❑o�r.ious�� ❑rervice ❑sicn ❑svnreroiin�, aooi. a <br /> DESCRI6[WORK �^A ^ <br /> 7it9`4AL2 5e?t :?teQ'tih_"i T.rl.zC+�2;. � i t i <br /> PROPOSED USE <br /> MECHANICAL <br /> l'VPEOFFUEL �OiL �NAT. �LPG. �ELEC. <br /> L[GAL DESCRIPTION OF PPOPERTV ISHOW OELOW OR ATTnCH G1�5 <br /> Fouq,�OF�sI 3g ��� G NO. TYPE OF EDUIPMENT FEE <br /> ns••�s <br /> LOT� pLOCK_OF <br /> �,NR COND. UNITS-H.R EA. 5 I <br /> REPRIGERATION UNITS-FI.P. EA. <br /> -- OOIL[PS-H.R EA. I <br /> _I GAS FIREp A.G UNITS-TONNAGE EA. <br /> l <br /> . OPCED AIR SYSTE�AS-p.T.U. M EA. I <br /> JOA ADDRESS WALL HEATERS-6.T.U. M i <br /> C�n S�CLQUS UNIT HEM[RS-B.T.V. M I <br /> CVl�PORl�TIVE [OOLEflS � <br /> I <br /> PLIiMBING CLOTHESDRYER$ I i <br /> VENTILl�TION FAN —T— <br /> RANGEY000 I <br /> NO. TVPE OF FIXTURE OR ITEM FEE AIR h1ANDLING UNIT- C.F.M. ' <br /> WAT[R CIOSET�TOII.ET) 5 �NCINERATOR I <br /> BbTHTU6 <br /> IAVATORV�WASH BASIN) I <br /> SHOWER <br /> KITCHEN SINK & �.dP. SUB TOTAL $ � <br /> DISHWASHER PERh11T 5� <br /> LAUNDflV TFAY TOTn�FEE 5 I <br /> CIOTH[5 WASHER THIS PERMIT BECOMES NULL AND VO10 'F WCPK OR CONSTRUG <br /> I WATER HEATER �— TION AUTHORIZED IS NGT �OMh1GNCEO WITHIN 120 OAVS, OR If- <br /> URINAL CONSTRUCTION OR WORK IS SVSPENDED Ofi �'+�ANUONEO FOR A <br /> OqINKING FUUNTAIN P=A�O� OF 120 DAVS AT ANV TIME AFTER WGRK IS COAIMENCED. <br /> I FLOOR-SINK OF DRAIN � �iEREBV CERTIFV THAT 1 HAVE REAp ANO EXAMINED THIS AP� <br /> VACUUId pREAKER` PLICATION AND KNOW THE SAME TQ 6E TRUE AND COfiFECT. ALL <br /> ROOF DflAINS-RAINLEADERS PROVISIONS OF LA'NS ANO ORpIN.1NCES GOVERNING THIS TVPE <br /> �i OF WORK WILL 6E COM1IVLIED WITH WHETHEft SPECIFIED HEFEIN <br /> SINK ISEFVICE-OAR, ETC.) ~ OR NOT. THE GRANTING OF A P[RM�T DOES NOl' PqGSUME TO <br /> � — GIVE AUTHORITV TO VIOLATE OR CANCEL THE PRO\ ISIONS OF <br /> i ANY OTMER STATE OF LOCAL LAW ftEGULATIhG CONSTRUCTION <br /> � � Ofl THE PERFORMANCE OF CONSTRUCTION. <br /> SUB TOTAL <br /> � PERMIT 5 <br /> T9TALFEE 5 g� � � r� <br /> X !�+/�.l-/-2.z- �)(" � �<1h-.,/c� 3�t:-77 <br /> SIGNATUFEOFCONTRACTORORAUTH.AGENT OATE <br /> SIDEVARDGETBACK STFiEETSETOACK REARVARDSET�ACKPLnNCHECKNUM11�ER PLANCHECKFEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VPCANT SITE <br /> ❑vEs Orvo FEES VALUATION FEE � <br /> TYPE OF CONST. OCCUPANCY GROUP UN'OS OWELLING � I <br /> I S12E OF BLDG. NO. OF STGRIES MAX.000. LOAO OUILDING 5 �� � � I <br /> PLUMBING � I <br /> FIFE ZONE BASEMENT qEpUIREIONKLERS I <br /> ❑YES ❑NO MECHANICAL I <br /> SPECIAL CONDITIONS: p7HEq � <br /> I <br /> T <br /> - PENELTV SEC.7031e1 I <br /> L.— ITO7AL � j� <br /> PERMI7 VALIDATION <br /> WHEN PfiOPERLY VALIOATED (IN THIS SPaGEI THI515 VOUA 'EPMIT <br /> MPUf.�TI0N4CLCPTEU9P. PLANSCH[pCK�EOBY: AFPfVOV[O�OR45VANCCOY � <br /> I A4 . �: <br />