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1 <br /> J <br /> � the Evurg2�cn <br /> ��T� oF CONSTi�UCTION everett <br /> everett PERMlT <br /> LIiY II�tL }5985Y5 <br /> N[nn�.�vasnror�rnN <br /> 981�1 <br /> °`°' °` `°',''°''"" BUILDING MECHANICAL PLUMBING <br /> oE,-:�a�•.,<<�� <br /> OWNER MAILAODRESS ZIP 1'HON[ <br /> �:.:C •�. C•rr�.�..{�?37 ... ^ .� •.•r,� <br /> :�: � <br /> ARCHITECT OR �ESIGNEF MAIL AD�flE55 PHONE LICENSE NO. _��?.y� <br /> il <br /> GENERALCONTRACTOR i <br /> MAIL AODRESS PHONE�.+ LICENSE NO. <br /> ?+.:'82.C� S'j(j12y R�S'• Jc�la.�f'.�13?T �c'sf"�f'J't�'! <br /> MECHANICAL WNTPACTOR MAIL A�OFESS PHONE �ICENSE NO. <br /> PLUM�ING CONTRACTO(i MAIL ADDRE55 PHONE LICENSE NO. � <br /> W <br /> m <br /> PERMIT CLASSOFWORK � <br /> z <br /> OVIIDING � PLUMOING �MECHANICAL F I <br /> ❑NEW ❑AD�ITION ❑qLTERATION Q�iEPAIR � <br /> VALUATION OF WORK <br /> *� ,�y� � I <br /> 5 +.�lw ❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POO� W <br /> OESCflIOH WOPK — c�j <br /> a <br /> �'�� �'� .i-�vT?i� 'h�'.3f'�{'S�'`'�4 �0�7j � <br /> PROPOSED USE <br /> MECHANICAL ; <br /> TVPEOPFUEL �OIL �NAT. QLPG. �ELEC. <br /> IEGA�DESCRIPTION OF PROPEFTY ISHOW BELOW OR ATTACH Gl�S <br /> FOUR COPIE51 <br /> Lo7 oLOCK_OF NO. TVPE OF EUUIPMEN7 FEE <br /> AIR COND. UNITS-H.P. EA. 5 1 � <br /> REFRIGERATION UNITS-H.P. EA. <br /> HOILERS-H.P. [A. � <br /> GAS FIqED A.C. UNITS-TONNAGE EA. <br /> FORCEO AIR SYSTEMS-�.T.U. M EA. I <br /> JOD AO�RESS WAL�HEATERS-B.T.U. M <br /> � [�5l:"� FY ♦ <br /> UNIT IIEATERS-�.T.U. M I <br /> PLUMBING EVAPORATIVE COOLEflS <br /> CLOTHESORVERS � <br /> VENTILATION FAN <br /> RANGEHOOD � <br /> NO. TYPE OF FIXTURE OR ITEM FEE �+�R HANOLING VNIT- C.F.M. <br /> WATER CLOSETITOILETi g INCINERATOR � � <br /> BATHTV� <br /> _ �AVATORY IWASH BASIN) � <br /> SHOWER <br /> KITCHEN SINK& OISP. <br /> DISHWASMER . SUBTOTAL $ � <br /> LAUNDHVTRAY NERMIT 5 <br /> CLOTN[S WASIiEft TOTAL FEE 5 � <br /> WATER HEATER THIS PERh11T �ECOMES NUL� AND VOID IF WOFK OR GONSTRUC- <br /> TION AVTHOfl12ED IS NOT COMMENCED WITHIN 720 DAVS, OR IF <br /> URINA� CONSTRUCTION OR WCRK IS SUSPENDED OFi A�ANDONED FOR A � <br /> [1RINKIN(3 FOUNTAIN PERIOD OF 120 DAVS AT ANV TIME AFTER WOPK IS COMMENCED. . <br /> PI.00R-SINK OR OliAIN ' 1 HEREDY CERTIFV 7HAT I HAVE IiEA� AND E%AMINE� THIS AP- <br /> VACUUM �REAKERS �LICATION AND KNO1V THE SAME TO BE TRUE AND CORRECT. �11.L <br /> ROOF DRAINS-RAINLEADERS PROVISIONS OF L4W5 ANO OfiDINANCES GOVERNING THIS TVPE <br /> --- OF WORK WILL �E COMP�IE� WITH WHETMER SPECIFIED HEREIN <br /> SINK ISERVICE-OAR, ETC.) OR NOT, THE GRI�NTING OF A PERMIT ODES NOT PNGSUME TO <br /> GIVE AUTHORITY TO VIOLATE OR Cl�NCEL THE PROVISIONS OF <br /> ANY OTHER STAT[ OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFOftA1ANCE Of- CONSTftUCTION. <br /> SUBTOTAL _ h� <br /> PERMIT 5 --���- <br /> TOTAL FEE 5 J •+'l �/y+.''y] <br /> X �/ 9 + 7 <br /> SIGNATUREUFCOMRACTOROPAUTH.AGENT DATE <br /> SIOE YARD SETDACK STRELT SGTDACK YEAR VAROS@TIIACK PI.qN CHECK NUM9ER PLAN CHEfK FEE <br /> fEE RECEIPTNO. <br /> USE ZONE LOT AfiEA VACANT SITE <br /> ❑vEs ❑No FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING <br /> UNITS � <br /> SI2E OF �LDG. NO.OF STORIES MA%.OCQ LOAD DUILOING ��� � � <br /> PLUMBING L� <br /> FIREZONE BASEMENT fIHESPRINKLERS 7 <br /> FE�UIRED <br /> ❑VES ❑NO ��ECNANICAL � <br /> SPECIAL CONDITIONS' OTHER � <br /> I <br /> PENELTY SFG 9031a1 I <br /> TOTAI � 4�i(� <br /> PERMIT VAIIDATION <br /> WHEN PROPERLV VALIDATCD IIN TIIIS SPnCEI THIS IS YOUR PEqWIi <br /> nPPIIUtIONPCCC�TE00V- PL,�NSUIlCKC�OP 4pppOVfOfaH�$$UANC�fIY <br /> �� � <br /> .7 <br /> � <br /> � <br />