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"'�' E���'�����'���� CONSTR UCTION <br /> ,:�,� �,� evcrett <br /> everett PERMIT <br /> cirv t��n�� zse e�ms <br /> evenerr. wn ;,tizo� COMBINATION • BUILDING • MECHANICAL • PLUMBING <br /> OWNLft M/�ILAUDHE95 LIP PIItINE <br /> ��_-�1 N�p '° <br /> m <br /> nfiCHIIGCTORDL51GN6H h1A1L �1DOR(SS I'IION[ LICLNS[ NO. � <br /> � <br /> GENERI�I. CONTRACTOR MAIL l�DDRE55 PIIONF UCENSE N0. � <br /> Cb�z�. L�� 35s- 4��-s � <br /> MECH4NICAL CONTRAGTOR h`AIL AODRE55 PIIONE UC[NSE NO. � <br /> W <br /> m <br /> PLIIMEtINGCONTfiACTOR �tAILl�ODRESS PHONE LICGNSENO. ' / � � <br /> PERMI'f CLASS OF WOf�K -- � <br /> [[jt�CUM6W ATION � <br /> ❑ 13UILDING � PLUM�ING �MECHANICAL �v'' <br /> LpVEW ❑nUOITION ❑ALT[HATIUN ❑q[Pt11R <br /> VALUATION1OF WO1R-K - — -' ' <br /> S 2 \ �VJ[� � QO ❑OLMOLISH ❑PENCE ❑SIGN ❑$W�ry�MING Pp01. <br /> DESCRI6[WORK —�- <br /> �L.OG��E �."9—IST�r.: �.`� <br /> PROI'OSED USE <br /> MECHANICAL <br /> LEGA�DESCRIPTION Of PROPERTv ISHOW[3EI.OW OR AiT(1CH TVPE OF ENERGv <br /> FpUli COPIESI ❑GAS <br /> �p-� ❑ELEC. <br /> Lo7 � oLOCK `t�`H��V�T �V� � N�� TVPE OF E�UIPMENT FEE <br /> � __ —_—_-- _ _ _ <br /> AIR CON�.UNITS-H.P. EA. g � <br /> � �OrS {-r OF W ` Z _ nEF(iIGERATIONUNIT;_ ILP. EA. <br /> ' ❑OILERS -11.P. [A. � <br /> . FOFCED AIR SYSTEMS-B.T.U. MEA. <br /> I <br /> JO� ADORE55f j _i SPACE A. WALI HEMEFS - B.T.V. <br /> `�1� P� �� ST� UNITIIEAT[PS �❑.T.U. � <br /> PLUMBIMG ivnaonnrive coo�Eas <br /> CLOTHESORVEHS � <br /> � V[NTILATION FAN T <br /> RANGE hlOOp � <br /> NO. TVPE OF FIxTURE OR ITEM FEE Alq Hl1N�LING UNIT- C.P.M. <br /> BA7'H TUBS g — --- <br /> CLOTHES WASHER � -- - - � <br /> DISH WASHERS � __ _�'�'ATER HEATER ' <br /> FAC. BUILT PIREPLACE & CHIMNEY <br /> DRINKING FOUNTAINS � . I <br /> FLOOR UR/11N5 � GAS SVSTEM: NO OP OUTLET$ �- <br /> KITCHEN SINKS & UISP. i _ _ SUn TOTnL 5 �p <br /> BAR SINKS � __ pEqnvT 5 �jTO <br /> ftOOF ORNNS - RAIN LLADEflS i � � roinL FEE 5 � ,�jQO <br /> SHOWER BATHS THIS P[fip111 ❑ECOMES NVLL ANO VOID IF YJOqK OF CONSTHUC <br /> SERVICE SINKS TION�nur1101tIZ[o 15 No7 coMMENCEo tvIrHIN 12o DnvS, oR IF <br /> SUMPS - SEWAGC- PUMP CONSI NUCiION Of1 WORK I$ ;USP@NDED OR l�6ANOONED POp A <br /> URINALS I NERIOf] UF 120 �AYS AT nNY TIME AFT[R WO(iK IS COMMENCED. <br /> WATER CLOSETS I - I HEftEl1V CERTIFV THAT I Hl1V G REAU ANfJ E%AIAINEU THIS �1P <br /> WAT[R HEATEflS - ELECTRIC � P�ICATION AND Y.NO\N T11[SAPAF Tn[3L Tf1UE l�NO CORq[CT. n�L <br /> PqOVI510N5 OP LAWS AN� ORDINAKCES GOVEItNING THIS TVP[ <br /> WASfI BASINS � OF WOHK WILL U[ COMPLIED WITII WH[iH[R SPECIFIED IIEflEIN <br /> LAUNDRY THAYS OR NOT, TIiE GRANTING OF A PERMIT pOLS NUT PRESVMB TO <br /> � GNB AUTIIOf11TY TO VIOLATL OR CANCfL THE PROVISIONS OF <br /> - ANV OTII[R STATE OR LOCAL LAW HEGUL/1TING CONSTRUCTION <br /> � OR TIIE PE��ORMANCE OF CONSTRUC1lON. <br /> _ I � <br /> SUeTOTAL —�— <br /> i— <br /> PERMIT 5 • <br /> 70TAL FEE � X �� ; n�,���f_��� <br /> WATER SERVICE SIZE `� EiLOG. SUPPLY SIZE �� sicNnivaeo�coNif�ncro �oiinuni nceNi onr[ 12GJ <br /> SIDEVARDSET[tACK STRFETSETF3ACK HLARYARDSET6ACKPLt1NCH[CKNUh111ER PLANCHECKFEE <br /> 5 fi— 'ZQ� Z.D►= rEe aEceirr No. <br /> use zoNe �or nnen vncnNr sirE — �1/,�� �je•O O <br /> �-'Z 7 -�j�JZ � C�ES ❑No FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUV NO.OF DWhLLIN(: T— <br /> � � � � UNITS � — I <br /> _.— � <br /> 512E OF OIDG. NO. OF STOfi1G5 MA%.00C LOA� 6VIL�ING SZ �Z�4,QL) /�yt��Oa <br /> , L��J� <br /> ��� PLUMBING �� i�O <br /> PIRE20NE ❑AS`EM`ENT flfiESPRINI<L6R$ <br /> � �-{.Q R QyESEO [�ICU MECHANICAL <br /> SPECIAL CONDITIONS� DTHEH ���0 � <br /> _��1��c:C,t,��Y--�u n� v�'e��. � <br /> �A�q /,' -r PENALTv ;EC. 9031a1 I <br /> 742_'���_ ____-___' ___ _ --.I _ <br /> � TO7AL . .� � <br /> n -- �----- -- n C-) <br /> __ S' C {e� � � � � P I D TION c <br /> - �? � �^ H'����������1�1 ��1�E:� IIN 111IS SPi1CF.1 1116 Iti YpUIi PCIiNIT <br /> •7 1! J <br /> - �'� '`�' YO CI R R EC E I PF- <br /> - � Q--�;. '�UR RECEIPT . . �N.q��r 1'C� U <br /> �����,:�,�,��.������,r- -� <br /> .��,�,•,.,,�,:.����,. ����,a����<<�„�.:..�,�N�:�„�� f-IA�!� 1',.OU . <br /> --i • <br /> , � � r� �;,y �� ,- 24 � 71 <br />