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� <br /> � <br /> tlrr. Eveigrern <br /> C:TV P� CONSTR UCTION everett <br /> eve rett PERMIT <br /> bIV H>�l }59flPA5 <br /> [VEfll1[C(ASNINGION <br /> 98}01 <br /> �E°� °o�°^;o;���; BUILDING MECHANICAL PLUMBING <br /> GWNER y ��.�y MAILl�D�RESS !����y 21P PMONE <br /> ��+YLY i�Yi�V �- ��� :`W� �� :l�.tilW <br /> ARCHITECT OR DESIGNER MAIL ADOFE55 PNONE LICENSC: NO. �?�xt <br /> GENERAL CONTRACTOF MAI�A�DPESS PNONE LICENSE NO. <br /> MECHANICAL COWT�}R.�ACTOR MAIL ADfJfiESS PMONE LICENSE NO. <br /> .�i1 �IS '+iS1LZL l:'a � '�� .L�� 2Nw � <br /> PlUM01NG CDNTFACTOR MAIL ADDRESS PHONE LICENSE NO. W <br /> m <br /> � <br /> PERMIT CLA55 OF WORN � <br /> Z <br /> ❑�UILDING ❑PLUMDING �MECHANICAL = ~ <br /> ❑NLW [�ADDITION ❑ALTERATION ❑REPAIF � <br /> VALUATIOIJ OF WORK � <br /> ❑OEMOLISH ❑FENCE ❑SIGN ❑SWIMMING YOOL W <br /> s a <br /> OESCRIBE WORK ���� <br /> YRDPOSED USE MECHANICAL <br /> TVPEOFFUEL �OIL �GAns. �IPG. �ELEC. <br /> LEGAL C�ESCFIPTION OF PROPEPTV ISI10W f3ELOW OF ATTACIi <br /> FOV F COPIE51 <br /> NO. TVPE OF F.DUIPMENT FEE <br /> LOT OLOCK—OF AIR COND.UNITS-H.P. EA. 5 � <br /> RLFRIGFRATION UNITS-H.R EA. <br /> DOIL[RS-NR EA. I <br /> GAS FIFED A.C. UNITS-TONNAGE EA. <br /> FORCED AIR SYSTEMS-D.T.U. M EA. I <br /> JOB �Q OR SS WALLHEATEfaS-O.T.V. M <br /> 1� �Lt UNIT MEATEPS-6.T.U. M <br /> EVAPONATIVECOOLEFS <br /> PLUM8ING CLOTHES DfivERS i <br /> VENTILA?ION FAN <br /> flANGEHOOD I � <br /> NO. TVPE OF FIXTURE OR I7EM FEF. A�R HANDLING UNIT- C.F.M. <br /> WATER LLOSETITOILETI g �NCINERATOfi _ I <br /> BATHTUB — ---- ' <br /> LAVATORY�WASH�ASIN) � <br /> SHOWER <br /> KITCHEN SINK& OISP. SU�TOTqL S <br /> DISHWASHER` 1'ERMIT $ <br /> LAUNOFV TRAY TOTAL fEE 5 <br /> CLOTHES WASHEfl 7HI5 PERMIT [iECOMES NULL AtJ� VOID IF WORK OR CONSTRUG <br /> WATER HE/�7ER TION �1UTHORIZEO IS NOT COMh1ENCED LNITHIN 120 DAVS, OF IF <br /> URINAL --� CONSTflUCTION Oft WORK IS SUSPENDED OR AEiANDONED FOR A <br /> PERIOD OF 120 DAVS AT AN�' TIME AFTER WJtiK ISCOMMENCED. <br /> ORINKING FOUNTAIN <br /> FLOOR-SINK Ofl ORAIN I 1iER[13V CERTIFV TI1AT I Hl1VE REl�O ANO EXAMINED THIS AP- <br /> PLICATION AND KNOW THE SAME TO BE iRUE AND CORRECT.ALL <br /> VACUUM OREAKERS PROVISIONS OF LAWS AND ORUIf<ANCES GOVERNING tH15 TVPE <br /> ROOF DRAINS-RAINLEADERS OF WORK WiLI BE COMPLIED WITH WNETH@R SPECIPIEO HEREIN <br /> SINK ISERVICE-AAR. ETC.1 OR NOT, THE GFANTING OF A PERMIT DOES NOT PftESUME TO <br /> GIVE AVTHORITY TO VIOIATE OR CANCEL TNL PROVISIONS OF <br /> ANV OTHEH STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> _�_ OR TIiE PEFFORMFNCE OF CONSTftUCTION. <br /> SUDTOTAL <br /> PERMIT S <br /> TOTAL FEE $ ,.��,�'/ <br /> X %�[l t V <br /> SIGNFTUREOFCONTRACTOFORAUTIi.AGENT D/1lE <br /> SI�EYAR�SETOACK STFEETSET6ACK HEARYARDSET�l�CKPLANCHECKNUMI3ER PLANCHECKFEE <br /> FEE RECEIPT NO. <br /> USE 20NE LOT AREA VACANT SITE <br /> ❑vEs ❑No FEES VALUA710N FEE <br /> TVPEOFWNSI. OCCUPANCYGPOUP UNIT�SDWELLING � <br /> —_ I <br /> SIZE OF BLDG. NO.OF STORIES MAX.OCC. LOAD UVILDING 5 � <br /> I PLUMBING � <br /> FIREZONE �1ASEMENT FIRESPRINKIEflS <br /> RfOUIqED � <br /> ❑VLS ❑NO MEGHANICAI <br /> I <br /> SPECIAL CONDITIONS: OTHER � <br /> PENELT'I SEQ�09 fal � <br /> TOTAL �( IAJ <br /> PERMIT VALIDATION <br /> WHEN PROP@RLY VALIDATED IIN THIS SPACEI iHIS IS VOUF FERMIT <br /> nPPIIC�T10NACCEPTEDPY�. PL/.NSOICIXEDOV�. A�PPJVCpfQP155U�NCEBY. <br /> 3 <br />