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� t6�• ,ctrn�n•en <br /> � ��� ; ,, CONSTRIICTION everett i <br /> I everett PEI�MIT' � <br /> � l9Y�b:1� ]S+PFL`. � <br /> '�"CP!11 �.:4SH'SLICN 1 <br /> I qP.:'I � <br /> i °�°' °"°""°""� gUILDING MECHANICAL PLUMBING � <br /> i oc�eioP��.r•.r <br /> I <br /> � OWKER MAILADDFL55 ZIV PHOY.� � <br /> � P8:1� �i0cl�t� �H.:L14 '�t! h'iMt� S�d3 3�'i C£�h <br /> I �qCNITEGT OR DE3IGNER M11AIL ADDRG55 PHONE LICEIJSE ^:O. qb.t_�L <br /> � � v!Y' �/ <br /> �;ENERAL CONTRAGTOF NAIL ADDRE55 PHONE LICENSE NO. I <br /> t�L �iar,�a iia� ��'� <br /> MECHANICALCONTRACTOR MAILAOCRESS PHONE LICENS[ NO. I I <br /> � PWM6ING CONTqACTOF MAIL AODRE55 PHONE LICENSE NO. w <br /> I � � ! <br /> I PERMIT CLASSOF WOHA J � <br /> I —_— z <br /> �pUILDIN� �PLUMBING ❑h1ECHANICAL H <br /> �N[`N ❑ADDITIGfJ ❑ALTERATION ❑H[PAIR <br /> 2 <br /> I 'JALUATION OF WORK � <br /> se�Y�'�C1wQ� ❑oFn+ous�+ C�'�r.ce ❑sieN ❑svnMMir:, Non�. a <br /> i ��E,,:���.�,�"� � -- ----- - -- 172 <br /> Irr�u�•oaen use MECHANICAL _ <br /> i_�.cAi.oescnirriorvorvnoaenrv �sr�ow��e�_owoiinirnc�+ rvaEOFFuei. poi� ❑"cns. ❑�ac. �e�ec. I <br /> Fouf��iEsi { <br /> iiYd �� D:{AI�Y,j� NO. T/PE OF E�UIPMENT FEE i : <br /> IAT BLOCK-04_-----______ AIftCOND. UN:TS-H.P. EA. •,S I 1 I <br /> REFRIGENATION UNITS-H.P. EA �—c <br /> t301LEFi5-H.P. EA. I <br /> G1�5 FIFED t1.C. UNITS-TONNAGE EA. <br /> FORCEO AIR SYSTEMS-9.T.U. M EA. I <br /> JOD A�D.�f;(n�55 WALL HEATERS-B.T.V. M <br /> ++w+! � I UMT HEATEPS-6.T.U. M I <br /> IEVnPORATIVECOOLERS <br /> PLUMBING j�c�orNes oavEFs I <br /> -'veNn�nnori Fnrv <br /> RnNGE1100D I <br /> TVPE OF FIXTURE OR 17EM E nlf: HnNDUNG UNiT- C.F.M. <br /> WATEFCLOSETITOIIETI —� 5 � INCINEHATOR I <br /> dl�THTUB <br /> I _ I.AVATUNV (WFSH pASIM _ _ _ { _ _ __ _ � <br /> SHOWFH_ <br /> KITCHBNSINk:& �ISP. ___ � __ SUpTOTAL $ I <br /> oISHW/�SHER { PERMIT 5 <br /> � LAI/NDRY TRAY � �fOTAL FEE 5 I <br /> CLOiHES WAaHEfl THIS PERIdIS' pECOMES NULI. ANO VOIO If WORY. Oii CONSTFVC- <br /> WATER HEATER f� TION AUTHORIZED IS NOT COMMEN'ED W!THIN 1]0 DAVS, Oq IF <br /> URINAL —� CJNSiRUGTION UR WOR�C IS SUSPEMDFO OR ABANDJNED FOR A <br /> URINKING FOUNTAIN PERID� CF 740 OA"d AT ANV TIME AFT[R WORK IS COMMENCED. <br /> FLDOR-SINK OR OPAIN I HEPEFY CERTIFV THAT I HAVE RE4U AND EXAh11NED TNIS I <br /> I VACUUM BREAKERS PLICnTION ANO KNOW THE SAME TO BE TftUE AND CORREGT. A' <br /> -� PP.OVISIONS UF LAWS AND OROINANCES GOV[NNING THIS TYf ! <br /> FODF ORqIN$-fiAINLLADERS OF WORK 1NiLL BE COMPLIED WITH WMETHEF SPEC!HEO HEREtN <br /> I SINK (SERVICE-DAR,ETC.) } OR 'JUT, THE GRnNTING OF A PER�9�t OOES NOT PRCSVME TO <br /> —f ---� GNE �UTHORITV TO VIOLATE OR �ANCEL TIiE PROVI;IONS OF <br /> �- -- .1NY JTHER STATE OR LOCAL LAVJ REGULATING CDNSTRUCTION <br /> {� . __ 04 THC PEHFOHMANCE OP COhSTViUCI'ION. <br /> SUE3 TOTAL <br /> FERMIT S <br /> TOTl�LFEE $ � �`� <br /> x %� <br /> '' SIGNP.TUPEOFCONTRACTOROHl�UTH.AGENT pATE <br /> � S�DIcYARDSETt3�CK STNEE 'SET�ACK HEANVAfl�SET9ACKPLl�f! CHECKNUP�R[R PLANCH[CKFE[ <br /> I <br /> �f/__1�M fEE !:A [�A (iECEIPT IJO. <br /> �1.�HGf Mw�N <br /> I US13 ZONE LOT AF9A VACANT SITE — <br /> I _ ❑vE5 ❑NO _ FEES VALUATION _ _ FEE I <br /> TY'PE OF CONST. OCCU�'ANCV GROUP `M1�'OIOS DWIiLLING � <br /> l I <br /> ! iIZE OF BL�G. NR OF STORIES MA%.OCG LOAD DUILOING §��� �q�I��y� I <br /> ' I PLUMBIN3 �y�W i <br /> FIRF. ZONE [iASEMENT RE�UIREIUKLERS _ i i <br /> . � ❑VE$ ❑NO MECHANICAL �___ I <br /> J� <br /> I SPECIALCONDITIONS'. � __ pTH[R --- I I I <br /> �____ . <br /> _--- PEVERY SLC.3071a) � <br /> — ".-�_ -_' <br /> "—" - TOTAL .�,�j�j� <br /> � � PERMIT VALIDATION <br /> WHEN PROPERLY VALIDATEO IIN TNIS SPACE)TM16 IS YpUH VLIi4111 <br /> IAIT4ICA(IONAf.I.TI`TCOflY' VIAN`vC11ECKG/O�BV. AI'PP(IY[Oi0pI551lPNLEO� <br /> I . ��v1 . ��V• ry��� � <br /> � I <br /> . � <br />