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, <br /> ,�,�• F,-��r�,���.,, everett <br /> �,TY o, CONSTRUCTION <br /> everett PE�MIT <br /> CILY NAII 159Bfi85 <br /> `°`a", '''°�"'"c`°" PLUMBING <br /> 9e"' BUILDING MECHANICAL <br /> o[rr.ar cui;uunnr <br /> OP'kiovi.RNi PHONE <br /> MAIL ADORESS Z�P �R� <br /> OWNEft �a� <br /> I 3�J ` '"�: ' .'• <br /> :��;,i+.�.Ii% F� •� � Y 4:a .'� PHONE LICENSENO. <br /> AFCHITECT UR OESIGNER <br /> MAIL ADDP.ESS <br /> PHONE L�GENSE NO. <br /> Ml�IL ADORESS 9'�,�,y� <br /> GENcRALCONTRACTOR � <br /> ��.�(���i.S i �J• :Z<.� `. PHONh LICENSE NO. <br /> MAIL ADDRESS <br /> MECHANICAL CONTRACTOR � <br /> MAIL ADORE55 <br /> PHONE LICENSE NO. m • <br /> PLVMBING GONTRACTOR � <br /> � <br /> CLASS Of WORK Z <br /> PERMIT ,..p � <br /> �6UILDING ❑ PLVMO�NG ❑MECHANICl�L ❑NEW �nppITION ❑ALTERATION I�T�EPA�A � <br /> � <br /> W <br /> VALVATIONOFWOFK �DEMO��SH ❑FLNCE ❑SIGN ❑SW�MMINGPOOL p, <br /> S �0°��' 17 2 6 <br /> DESCRIOE WORK �,.��,.� �,,..��lp�.� <br /> PROPOSED VSE MECHANICAL � �ELEC. <br /> TYPE Of- Fl1EL �n�� ❑GAS LPG. <br /> LEGAL DESCRIPTION �F PROPEPTY ISIiOW BEIOW OR ATTACM TVPE OF E�UIPMENT FEE <br /> FOUF C�OPIESI .i.��i�� � ::'r NO. S — I <br /> LOT lt� pLOCK—OF AIR COND. UNITS-�1.P. EA. — <br /> qEFRIGERATION VNITS-H.N. EF. I <br /> 001LER5-H?. LA. <br /> GAS FIfiED A.C.UNITS-TONNAGE EA. I <br /> ' / �— POFCEU A�A S�STEMS-9�T.U. M EA. �� <br /> ',.�y - WALL HEATEFS- ��T��1� M <br /> JOD ADDRE55 ���j.y.� .•. �� I <br /> UNIT NEATERS-B.LU. M —Z— <br /> EVAPO(anTIVEGOOLERS __� � <br /> I <br /> CLUTHES DR�ERS --�-Z-- <br /> PLUMBING VENTILAT�ON FAN <br /> _ __��_i <br /> RANGEHOOn <br /> AIR HANOLING UNIT- QF.M.__ � <br /> FEE � <br /> NO. TYPE OF FIXTURE OR ITEM INCINERAT(�H <br /> WATERCLOSETITOILETI 5 �-- � <br /> I <br /> BATHTVB �— <br /> �AVATO�VIWn5H9A51N1 <br /> SHOWER , SUBT<)Tn� 5 I <br /> KITCNEN SINK R OISP. PERM�T 5 <br /> DISNWASHER TOTA.L FEE S � <br /> LAVNOFVTRAY <br /> CLOTHES WASHEF �—,� THIS �'ERMIT 6ECOMES NULL AND VJID IF WORK OFl CONSIR � <br /> TION AUTHORI2[D IS NOT COMMENGEO 1NITHIN 120 DA�'S. OR IF <br /> WATER HEATER �ONSTRUCTION OH WURK IS SUSPCIJ�ED UP ndnNDONED FOR A <br /> URINAL . PERIOD OF 120 DAVS AT AN�' TIME AFT'iR WORK IS COMMENCED. <br /> DRINKING FOUNTAIN � H[FE6V CERTIFY TNAT 1 HAVE PEAD AND E%ANINED THIS AP� <br /> FLUOR-S�r1K OR DRAIN _ PLICl1TION AND KNOW TM[SAME l'O 6E TRUOVEFO NGRTH STTVPE <br /> VACVUM BREAKERS PROVISIONS Of- l.AWS nND OnDINANG[.^. � <br /> RCOF DFAINS-RAINIEADEfiS OF WORK W�LL �E COMPLIEO WITH WHETHER SPEGFIED HEREIN <br /> SINK (SEftVICE-UAR.ETC.1 <br /> G VE AUTNOf1 TVnTOIV OL�I�TE ORRCANCELET�E�PF70VISYONS OP <br /> �_ pp T�E PERFOR 1ANCE OF CONSiPUCT ONAT�NV CONSTRU <br /> SUB TOTAL � <br /> PERMIT 5 •1A�lA'lr <br /> TOT�1L FEE 5 i��yi(/ ��+ <br /> SIGNATUREOFCONTRACTORORAUTH.AGENT OATE <br /> �P�AfJC11ECKfEE <br /> ��pEypRO5ETf3ACK STHEETSETBACK FiEl�RYl�RDSETC�ACKPLANCMECKNUMBEF FEE �RECEIPTNO. <br /> �OTAREA VACANTSITE � FEE <br /> USE ZONE FEES VALUATION <br /> ❑VES ❑NO —___ 1 <br /> TVPE OF OCCUPANCV GROUN VNIT�S �WELLING �M <br /> ___— � f'aft W <br /> 5 �..n+ <br /> NO.OF STORIES Ml�X.000. LOAD [3UILDING �-1--- <br /> SIZE OF OIDG. �� � <br /> PWME'�ING � <br /> RRESPRINKL[RS � <br /> FIRE 20NE Dl�SLMENi qCOU1PED � <br /> MECHANICAL <br /> ❑VES ❑N� I <br /> OTHER � <br /> $pEC1AL CONUITIONS: � <br /> -- PENEL�V SEQ 9091a) � <br /> .-- — c�..l l� <br /> — TOTAL <br /> PERMIT VALIDATION <br /> W�'GN PROPERIV VAIIDATED I W 1���5 SPACEI THI� IS VOUR�'ERMIT <br /> rinr�,o�ecKmo+'�. nrvnov�oFonissunHcrer. <br /> nrrucnnouncc[rironr. � .� <br /> 3 <br />