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rAc frc�grcen I <br /> �,r� �,F CONSTRUCTION everett I <br /> everett PERMIT <br /> CIL!Nell i53PA9f <br /> [VCPfi1.15n$NINGION <br /> 9R01 <br /> o��, �< <��,M���,� BUILDING MECHANICAL PLUMBIN <br /> OFV[lOVMFMi <br /> Z�p PMONE <br /> MAIL ADDFC55 � <br /> OWNER � - <br /> ,♦�+�' _�. �.�•!Yr <br /> Iy'� r Ii+�,'.".Tt L.J1�7i . _ ..... . LICENSENO. <br /> ARCHITECT OR OES�GNER <br /> MAIL AOORE55 PHONE <br /> GENLRALCONTRACTOR <br /> MAIL ADORESS PHONE LICENSE NO. <br /> MAIL ADDRESS PHONE LICFNSE NO. <br /> MECHANIGALCONTPACTOF � <br /> � � � � <br /> MAIL A�DRESS PHONE LIGENSE NO. �L , <br /> PLUMBING CONTRAGTOR �� <br /> � <br /> PERMIT Cl/�5S OF WORK Z <br /> F <br /> ❑DUILDING ❑ PLVMBING �]MECHANICAI �NEW �pODIT10N ❑ALTEFl+TION ❑REPlaIF � <br /> � <br /> VALVATIOIJ OF WORK W <br /> ❑OEMOLISIi ❑FENCE ❑SIGN ❑SW�MMING POOL a <br /> s �O�V <br /> DESCRIBF WORK �g•�,,- �S.-�1���+�'. <br /> PROPOSED USE MECHANICAL <br /> TVPCOf �U[L �OIL nGA� ❑�PG. �EL[G. <br /> FOUR CO�SESI���T�ON OP VROPERTV ISHOW�E�OW OR ATTACM FEE _ <br /> NO. T\'PE OF EOUIPMENT 5 <br /> l0T BLOCK_OF AIR COND.VNITS-M.P. EA. <br /> PEFPIGEfiAT10N VfJITS M.R EA. <br /> �OILEFS-M.P. EA. � <br /> GAS FIRE�A.G UNITS-TGNNAGE EA. <br /> FOPCED NR S�STEMS-B.T.V. M EA. � <br /> - W/1Ll HEATEPS-U.T.U. M <br /> JOB AODRESS }A =r,�C � <br /> y��y UNIT IIEATERS-P.T.U. M <br /> ��1� <br /> EVAPORATiVECOOlEFS <br /> PLUMB�NG _ <br /> CLOTNESDFVERS � <br /> V[NTILATION FAN <br /> RFNGENOOO ' <br /> NIH HFNDLING UNIi- 0.F.M. _ <br /> NO. T'PE OF FIXTURE OR ITEM FEE �NCIIJERATO(i � <br /> WATER CLOSET ITOILETI s � Q �r <br /> BATNTUB I <br /> LAV/aTORY (�'dASH DASIN) — <br /> SHOWER -- SUBTOTAL $ I <br /> K�TCHEN SINK & O�SP. - pEflM1T S <br /> pISNWASHER •OTALPEE 5 <br /> LAUNOf?V TRAV <br /> CLOTH[5 W�+SHER THIS PERMIT BECOMES NULL AN� VOID IF WOHY. ON CONSOF F <br /> WATER HEA'�f.R TION AVTHOFIZE[) I^o NOT LOMMENCED WITHIN 120 O�VS. <br /> CONSTRUCTION O� WORK IS SUSPENDED OF AI3ANOONEO FOR A <br /> URINAL PERIOD OF 120 DAVS AT ANV TIME AFTER WORK I$COMMENCED. <br /> DF�NY.ING FOVNi��N i �1ERE�V CEfiTIFV THAT 1 lil�VE f�EAD ANO EXAMINED THIS AP� <br /> PLOOH-SINK OR nFA1N p�ICN110N AND KNOW iHE SAME TO BE TftU[ AND CORFECT. ALL <br /> VACVUM 9REAKEf�^u PPOVISIONS OF LAWS ANO ORDINANCES GOVEIiN�NG THIS TVPE <br /> ROOF �RAINS-RAINLEADEF$ —��� OR NUTK��E GPANT�INGLO Dn �Elah1 TEDOES NOT IPfa[DU�E TIO <br /> S�NK (SERVICE-�AR,ETC.) GIVL AUTHORITV TO VIOLATE Oli Cl�NCEL THE PROVISIONS Of <br /> qNY OTHER STATE OR LOCAL LAW REGUInTING CONSTRUCTION � <br /> OR T41E PEPFORM�NCE OF CJNSTRUCTION. <br /> SUBTOTAL _._� <br /> PEHMIT $ y <br /> -- — TOTAL FE= 5 y�'�� �t� <br /> X <br /> SIGNATUFEOFCONT(iA�TORORAVTH.nGENT DAIF <br /> CLAN CHECK Ff:E <br /> SIDE VARO SF.TBACK STREET SET�ACK PEAA VARDSETBACK PLGN CIiF.CK NU�46GR `EE qECE1PT N0. <br /> VSE ZONE LOT AREA V/�CANi SITE I <br /> ❑vEs ❑No FEES VALUATION FEE <br /> TVPE OF CONST. OCCUPANCY GROUP Nn.OF D`NELLING � <br /> UNITS <br /> -- 1 <br /> MA%.OGC. IOnD AUILDING $ � __ <br /> SIZE OF BLOG. NO.OF STORI[5 _ _ I <br /> PLUMBIWG <br /> FIRE 20NE BFSEMENt FIRESPNINKLERS � <br /> RC�UIfiED MECHANICAL �� <br /> ❑VES ❑N� � <br /> SPEGALCOND�tIONS' OiHEP � _— <br /> PENELTI <br /> SEC. :1031,i1 � <br /> — — — 5�� <br /> __ TOTAL � <br /> PERMI7 VALIDATION <br /> — WN[N PftOPERLY VALIDATEO UfJ��iIS SPnC[I THI315 VOVA PERMIT <br /> I <br /> i' — I <br /> i - <br /> r�'t'Lu1i:�l�r.r�.1'lft�llv �'IL•.'C�IC(;vCOP.Y. <br /> P1'CPOV[1>fOM1I^:UPNC! XV � <br /> .G� r{ I <br /> � <br />