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lhr Erer�icen � <br /> '; =�T� oF COIV�TRUCTiON everett I <br /> ever�tt PERMIT <br /> �.iVN>IL 15'Jitie: <br /> � L2fNf1I.C.a9LL'�G10N <br /> 9B1a1 <br /> °E" °` �°"^'°'°'r BUILDING MECHANICAL PLUMBING <br /> o[vtiavutwr <br /> OWAcR MAILADDFES;: Z�p PHONE <br /> .�.'.�.� �C`'�t+-�'�f.f� �i:i: i' _ . <br /> ARC4VITECTORDESIGNEH MAILAOORE55 PHONE LICENSENO. ,ui�r��MJi} <br /> GENERAL CONTRACTOR MAIL ADOFESS PHONE LICENSE NO. <br /> MECH NICALCONTFACTOR MAIIADORESS PHONt LICENSENO. <br /> �3 E <br /> FLUMBINGCONTRACTOR MAII ADORESS PHONE LICENSENO. � I � <br /> W <br /> m <br /> ���MIT CLA55 OF WpRK � <br /> z <br /> ❑t3UILDING ❑ PLUMBING �v1ECHANICAL m'� f- <br /> I ❑NEW ❑I�DOITION ❑ALTERATION IJREPAIfl � <br /> VALVATION OF WORK (t <br /> 5 ❑DEMOLISH ❑F@NCE ❑SIGN ❑SWIMMING POOL a <br /> DESCPIp[WORK � n7 <br /> � �S �` � �V ! � <br /> Ff10PO5ED USE MECNANICAL <br /> LE�iAL DESCRIPTION OF PROP[HTY 6VIUW LLLOW OR ATTACH TVPE OF FUFL �OI1. ❑Gn5 ❑LPG. �FLEC. <br /> POUR COPIE51 <br /> LOT oLOCK—OF NO. TVPEOFEQUIPMENT FEE <br /> AIfl CONO. UNITS-H.P. EA. 5 I <br /> flEFFIGEflAT10N UNITS-H.P. EA �- � <br /> I - BOLLERS-H.R 64. 1 <br /> GAS FIREO A.C. UNITS-TONNAGE EA. T <br /> FORCED AIR SYSTEMS-O.T.U. M EA. I <br /> I JOH ADD9E55 �� �..''.� _ WqLL HEATERS-H.T.U. M �— <br /> I �� 'UNIT HEl�TLRS-�.T.U. M _ I <br /> EVAPORATWE COOLERS <br /> ! PWMBING CLOTHES or+vEas i <br /> � <br /> IVENTILATION FAN <br /> � RANGEHOOD I <br /> � NO. NPE OF FIXTURE OR ITEM FEE A�R I�fANDLING VNIT— C.F.M. <br /> WATEF CLOSET ITOILET) 5 �NU EPATOR _ I <br /> un i�+ruis <br /> Lf.VATOa1'ONASH 9ASIN) I <br /> __- .,iHOW[ii �-- -- T— <br /> IUICH[N SINK& OISP. SUE TOTAL 5 ��� <br /> DItiHWnSHER PEFMIT 5 <br /> I_/�UNDflVTRAY TOTALFEE 5 ��� <br /> GLOTFI[SPIASHER THIS PEFMIT BECOMES NULL ANO \'OID IF WOHK OR CONSTRUC- <br /> WAT[R HGATER TION AUTHOR12ED IS NOT COMMENCLD WITHIN 120 DAYS, OR IF <br /> UFINAL CONSTRUCTION OF WORK IS SUSPENDED OR A�ANDONEO FOR A <br /> DRINKING FOUNTAIN PfRIOD OF 120 DAYS AT ANl' TIME /1FTER LVORK IS CnPdMENCED. <br /> FLOOH-SINY. OR �RAIN I HEHE[3V CERTIFV THAT I HAVE RE/�D I�NO EXAMINED THIS AP- <br /> VACUUM 6PEAKERS PLICATION AND KNOW THE SAME TO BE TFiUE AND COFiRECT. ALL <br /> PfiOV1510N5 OF LAWS ANO OfiDIN4NCE5 GOVERNING THIS TVFE <br /> ii00F ORMNS-9AIN�EADEflS OF WpRK WILL UE COMPLIE� WiTH WHETHER SPECIFIED IIEREIN <br /> SINK ISERVICE-BAR, ETC.) OF NOI, THE GFANT-INC OF A PFERMIT DOES NOT PRESUME TO <br /> — GIVE AUTHORITY TO VIOIATE OF CANCEL THE PqOVISIONS OF <br /> 11NV OTHER STAT@ Ofi LOCAI, LhW REGUTATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTfiUCTION. <br /> SV6TOTAL <br /> PERMIT 5 <br /> TOTAL FEE 5 ��� <br /> x <br /> SIGNATUREOFCONifiACTORORAUTH.AGENT DATE <br /> SI�E 1'AfiD SET�3ACK STREET SETI3ACK qEAR VARDSETf3HCK PLAN CHECK NUMBEF PLAN CHEf.K FEE I <br /> ' FEE FLCGIPT NO, I <br /> � USE ZONE LOT AREA VACANT SITE I <br /> ' ❑vES ❑No FEES VALUATION FEE <br /> � TVPE OF CONST. OCCUPANCV GROUP N0.0F DWELLING � <br /> I UNIlS I I <br /> SIZE OF BIDG. NO. OF STORIES IAA%.00C. LOAO BUILOING 5 � I <br /> I <br /> PLUMBING � <br /> FIHeZONE BASEMENT PIRESPRINKLERS _ <br /> Ff�UIRED �� <br /> ❑YGS ❑NO M[CHAMICAL ,��� <br /> _ � <br /> SPECIAL CON�IT�OkS. pTHER � � <br /> � PENELTV cEC. 80:)fal I <br /> I <br /> TOTAL s jQQ <br /> PEtiMIT VALIDATION <br /> WHEN aqOPER�J VAl IDATEp IIK IHIS::PTC[1 TH1515 YOUli PCRMR <br /> :.rp�ii.::u�,l:,L<:Ivn�i�.� ^Lnry5L11ECRCDOT� /.PPROV Of081SSUPUC[Flv <br /> � �. r• ,� <br />