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thr` FrevGrer`n <br /> �„� o� CONSTRUCTII�N everett <br /> everett PERMIT <br /> CIIY H4LL A9fiAfi5 <br /> FVFPER.CAS�IiNGiON <br /> IiECI.0�COM1!M11UN�IIY <br /> ot�E,a,�E„, BUILDING MECHANICAL PLUMBIN <br /> OWNEfl MAILADDRE55 ZIP YIiONE <br /> TRQIk? ��.+�" y�7 !'itF': -�`v� �+i-�.� <br /> AFCHITECT OR DES�GNER MAIL ADDFESS PHONE LIGENSE NO. <br /> GENERALCONTRACTOP MAILA�ORESS PHONE LICENSENO. <br /> l.tECHANICAL CONTRACTOR MAIL ADORESS PHONE UCENSE NO. <br /> 3#nt. ^.S A ?,c�.F+ ('p 1fiT.7. T'• CC� !m3 0[ <br /> PLUMBING CONTRACTOR MAIL ADDRESS PHONE IICENSE NO. �yJ <br /> m <br /> � <br /> PEFMIT CLASS OF WORK � <br /> z <br /> �6VILDING ❑PLUM�ING �MECHANICAL S ~ <br /> �N�yy ❑ADDI`ION ❑�+LTERATION ❑REPAIfi � <br /> � <br /> VALUATION OF WORK W <br /> ❑DEMOLI511 ❑FGNCE ❑SIGN ❑5\NIMMING POOI a <br /> 5 �� 1 � <br /> DESCRIBE WOFK <br /> PROPOSED USE MECHANICAL <br /> TVPE OF f-VEL �OIL ❑GAS ❑LPG. �ELEC. <br /> IEGAI DESCRIPTION Of PFOPERTV ISMOW BELOW OR ATTACN <br /> FOUR COPiEsI NO. TVPE OF E�UIPMENT FEE <br /> LOT OLOCY.—OF AIR COND. UNITS-N.P. EA. 5 I <br /> REFRIGEFiATION UNITS�-H.P. EA. <br /> BOILERS-M.P. EA. � <br /> GAS FIRED A.C. UNITS-TONNAGE EA. <br /> FORCEDl�IR SVSTEMS-9.T.U. M1i EA. � <br /> JOflADDRESS WALLMEATERS-U.T.U. M <br /> Arr,� � r`�. VNIT HEATEFtS-B.T.U. M � <br /> afi�+ <br /> EVAPORATIVECOOLERS <br /> PLUMBING CLOTHLSDRVERS <br /> V ENTIL1ITION FAN <br /> RANGEHOO� � <br /> AIR HANOLING UNIT- C.F.M11. <br /> NO. TYPE OF FIXTURE OR ITEM FEE iNCINERATOa � <br /> WATER CLOSET ITOILETI 5 <br /> 13ATHTVO � <br /> LAVATORYIWASNk1ASIN) <br /> $HOWEF <br /> KITCMEN$INK R OISP. SUB TOTAL 5 � <br /> DISHWASHEP PERMIT 5 <br /> LAUNOR�' TIiAY TOTAL FEE S � <br /> CLOTHESH'n511ER TIilS PERMIi OECOh1E5 NULL FND VOI� IF WORK Oft CONSTPVC- <br /> WATER HEAIER _ TION AUTHORI2ED IS NOT COMAIENCEO WIl'HIN 1:0 DnVS, OR If- <br /> URINAL CONSTRUCTION OR WOFK IS SUSF`ENDLO Ofl A�ANDONED FOR l� <br /> PERI00 OF 120 DAVS AT ANV TIA1E 11FTER WOFK IS COMMENCF.D. <br /> �RINKINGFOUNTAIN <br /> FLGOR-SINK OR DRAIN I HEREOV GERTIFV THAT I HAVE READ AND E%AMINED THIS AP� <br /> PLICt1TION AND KNOW THE SAAtE TO[3L TRVE ANO CORfiECT. ALL <br /> VACUVM �REAKERS PROVISIONS Of- LAWS AN� ORDINANCES GOVERNING THIS T\'PE <br /> ROOF ORAINS-RAINLEADERS OF WORK WILL �E COMPLIED NITN WHETHER SPECIFIEO HER'_IN <br /> SINK (SERVICE-BAR.ETC.1 OR NOT, THE GRANI ING OF A PERMIT DOES NOT PFESUNE TO <br /> GIVE AUTHOFiITY TO VIOLATE OR CANCEL THE PPOVISIONS OF <br /> 4NY OTHEH STATE 04i LOCAL LAW REGI�LATING CONSTRUCTION <br /> _ OR THE PERFOiiMANCE OF CONSTFUCTION. <br /> SU6 TOTAL <br /> PERMIT S <br /> TOTAL FEE 5 '?t°I�'�� <br /> x <br /> SIGNATVREOFCONTRACTOfiORAUTH.AGENT D!�'fE <br /> SIDE YARD SETBACK STREET SETOACK NEAR VARDSETE3ACK PLAN CMECK NUMDER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE 20NE LOT nREA VACANT SITE <br /> ❑YES ❑No FEES VALUATION FEE <br /> I T�PL OF CONST. OCCUPANCV GROVP uN'OS OWELLING I <br /> I <br /> SI2E OF BLDG. NO.OF STORIES M11A%.OCC. LOAO BUILDING S I <br /> I <br /> PLUMUING <br /> FIRE ZONE �ASEMENT FIRESPRINKLEFS � �' <br /> RfOUIRED MECNANICAL <br /> ❑YES ❑NO <br /> I <br /> SPECIAL CON�ITIONS' OTHER I <br /> PENELTY SEC. �07101 � <br /> TOTAL <br /> 5 +s� <br /> PERMIT VALIDATION <br /> tVMEN PfiOPEf1LY V ALIOATED (W THI;SPACG) THIS IS YOUR�E RM1iIT <br /> N'1`LIf:.110NACCfPTCDOY' �Lf�NSC1IECKE00Y�. AP�IIOVLOfO111S`.�A.GLIIY <br /> �� <br /> .� <br />