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tlla E�Trg�]pil . � <br /> , _�„ -�� CONS'TRUGTION everett i <br /> � e�erett PERMI'f' ! <br /> � PiY11AlL !i3-.-' <br /> � CVEPFii.'iIASNrt.0:P. � <br /> 3,I.11 � <br /> °"T °"°"''°';°, BUILDING MECHANICAL PLUMBING <br /> ,I OFVEl0Y:i4 I <br /> � OWNEF MAILADDftESS ZIP i'HU>'E ' <br /> 1 .�t���_77 I <br /> � 5tcp:3a�ie S. Cazlsois �?��3 Lw7wacl ;�r. SCiu'- <br /> ARGHITECT OF OESIGNEF MAIL ADOFE55 PMONE LICI:NSE NO. <br /> '� GENERALCONTRACTOR MAILADDAESS PHONE LICENSENO. <br /> Lako Si3Q:11agtoa F�Svd. 3�4r; Drsna^are :.12-334� Ri�3C-r�3P2ii-"? i <br /> � <br /> MECHANICAL CONTRACTOR MAIL ADDFES$ PHONE I.�CENSE NO. il <br /> I PLUMBING CONTAACTOR MAIL A�ORE55 PHONE LICENSE NO. � I , <br /> W <br /> m � <br /> � <br /> PERMIT CLASSOF WORK � I <br /> z <br /> I ❑pUILDING � PlUM01NG ❑�1ECHANICAL `� � <br /> � ❑NEW ❑AODITION ❑ALTERATION �FEPAIP � <br /> �� VALUATION OF WORK � <br /> � � ������ !�4� ❑OLR10L13H ❑FENCE ❑SIGN ❑94VIMMING PUOL � <br /> IDESCFIB[WONK <br /> I ra?^.ir fiire dar.snae G�1� <br /> PROPOSED USE MECHANICAL <br /> �iKRY� t)u�lex -- <br /> LEGAL DESCRIPTIONOF PftOPERTV (SHOW f3[lOW OF ATTACM TYFF OF FUEL �OIL �C^T. �IPG. �ELEC. �I <br /> FOUfiCp PIE51 <br /> 3 IZJ L7tl1'3Lt B.�.Y. i NO. TVPEOFE�UIPMENT FEE I <br /> LOT BLOCK_OF <br /> Alfi COND. UNITS-H.P. EA. $ I <br /> I REFRIGEFATION UNITS-H.P. EA. —�— <br /> I _. I[101�ER; H.P. EA. I <br /> �GAS FIPEO AC. UNITS-TONNAGE EA. <br /> � FORCED AIR SVSTEMS-B.T.U. M EA. I <br /> i <br /> I JOj3 [�jJ[2F�S�5 WA�L HEATEfiS-B.T.U. M <br /> f�Tjy �`rnr�CL UNITHEATERS-tI.T.U. M I <br /> � EVAPOFATIVECOOLERS <br /> ' PWMBING CLOTHESDFVERS I <br /> I VENTILATIONFAN � <br /> FANGEHOOO I <br /> iNO. NPE OF FI%7URE OR I7EM FEE �+IR HANDI.ING UNIT- GF.M. <br /> WATEPCLOSFTITOIIETI g INCINEPATOR I <br /> 6ATHTUB <br /> L/1VATORY �WASH BASIN) � <br /> $H O W[R --�—— —�-- <br /> . KITCHENSINK& �ISP. SUB TOTAL 5 � <br /> il DISIIWASMER P�RMIT 5 <br /> LAUNDFY TfiAY TOTAI FEE 5 <br /> I CLOI'HCS WASHER THIS PERMIT �ECOMES NULL AND VOID IF WORK OR CONSTRUG <br /> WATER HEATER TION AUTHORIZED IS NOT COMAIENCED WITHIN 120 Di Y5, OR IF <br /> URINAL CONSTRUCTION Ofi WORK IS SUSPENDEO Ofl ApANOONcD FOR A <br /> DRINKING FOUNTAIN P[RIOD OF 120 DAYS AT ANV TIME AfTER WOF:: IS CpMMENCE�. I <br /> FLOOH-SINK OH ORAIN I HEPE9V CERTIFV THAT I MAVE FEAD ANO E%AMWED TNIS AP- I <br /> '� VACUUM 6REAKERS PLICATIJN AND KNOW THE SAME TO BE TFUE AND CORiiECT. ALL <br /> � PIIOVISIONS OF LAWS ANU ORDIN{1NCE5 GOVEHNING THIS TVPE <br /> �, ROOF ORAINS-RAINLEADERS OF WOqK WILL BE CGMPUEO WITH WHGTHER SPECIFIED HEREIN <br /> � SINK (SEFVICG-E3AR, ET0.) OR NOT, THE GRANTING OF .4 PEPMIT DOE; NOT PRLSUME TO <br /> GNE AUTNORITY TO ViOLATE OC CANCEL THE Pf10VI510N5 OF <br /> ANV OTHER STNTE OR LOCAL LFIV REGULl�TING CONSTRUCTION <br /> OR THE PERFORMANCE OF CON5T9UCTION. <br /> SUBTOTAL <br /> FERMIT 5 <br /> TOTALFEE S 7��'i�IT <br /> X <br /> SIGNATUREOFCONIftACTORUfiAUTH.P.GENT DATE II <br /> SIDE YAqD SEi�ACK STRFET SET�Af.K REAR VAflD5ET6ACY. P'_AN CHECK WUMOER PLAN CHECK FEE <br /> �I PEE FECEIPT NO. <br /> ' USE ZONE LOT AREA VACANT SIiE �I <br /> �I ❑vEs ❑No FEES VALUATION FEE I <br /> TVP[ OF CONST. OCCUPANCY GPOUP NO.OF DWELLING <br /> UNITS � <br /> SIZE OF BLOG, NO.OF STOHIES MAX.00C. LOAO !3UILDING S � � f <br /> I <br /> i PLUMBING � <br /> F�IHE20NE �AS[MENT FIRESPfiINKLEFS <br /> flCUUIlYED � <br /> I ❑YES ❑NO h���MANICAL I <br /> SPECIALCONDITIONS: OTIiER � <br /> I <br /> __. — PENELTV SEC.3031e1 � � <br /> I --- — TOTAL I I <br /> PERMIT VALIDATION I <br /> VJH[N PqOPERLY Vl�LIOM[D (IN THi55PACE)THIS IS YGJH PERPAIf � <br /> � I <br /> � <br /> � <br /> � <br /> I APpLIGT10NPCCEPTFOBV'. PLFNSCIIELKEOBY. APpl10v[�f0111S1On4[C9Y I <br /> i .� r• i <br />