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� <br /> thc Everg�een <br /> ��TYOF CONSTRUCTION ev�rett <br /> evel�ett PERNEIT <br /> ❑IV IIALI }5'IBftHi <br /> fVEPE1t,lYFSHIHGIOH <br /> 9B101 <br /> °`�' °p��E�;a�„, BUILDING MECHANICAL PLUMBING <br /> OWNER Mt11LAODfiESS ZIF� F'HONE <br /> i�� � iriK !� �:�+.�.� � <br /> l�RCHITECT OR DESIGNtR MAIL AODRE55 PMONE LICENSE NO. � � <br /> GENEPAL CONTfiACTOR MNL ADORE55 PHONE LICENSE NO. � <br /> MECHANICA�CONTRACTOF MAILADDRESS PIiONE LICENSENO. <br /> PLUM131NG CONTRACTOR Ml.IL 4DDRESS PHONE LICENSE NO. � <br /> W I <br /> m <br /> PERMIT CLASS Of WORK � <br /> � <br /> ❑BUILDING �]PLUMBING []SiECHANICAL L <br /> �NEW C�UOITION ❑ALTERATION ❑REPAIR ~ <br /> VALUATION OF WORK � <br /> 5 <br /> ❑DEMOLISH ❑FGNCE ❑SIGN ❑5�'JIMMING POOL W � <br /> DESCPI�E WORK — <br /> ai <br /> �ee ;tzbe�l' �.tv+co a 9 3 a <br /> PROPOSED USE <br /> MECHANICAL � <br /> LEGAL DESCRIPTION OF PROPERTV �SIiOW�ELOW OR ATTACIi TVPE OF FUEL �OIL �GAS, �LPG. �ELEC. <br /> FOUR COPIESI <br /> LO7 9LOCK—oF NQ• TYPE OF EDUIPMENT FEE <br /> AIR COND. UNITS-H.P. EA. 5 � <br /> _ REFRIGERI�TION UNITS-H.P. EA. /i <br /> �OILEPS-H.P. EA. � , <br /> GAS PINED AC. UNITS�-TONNAGE E,1. <br /> FOfiCEO AIR SYSTEMS-B.T.U. L1 EA � <br /> JOB AODFE55 }y�, WALLHEATERS-�.LU. M <br /> � `�� UNIT IiEATERS-6.T.U. M I <br /> PLUMBING _ Evnroannvecooi.�as <br /> CLOTNES DRVEfiS � <br /> VENTILATION�AN <br /> 19ANGG HOOD � <br /> NO. TVPE OF FIXTURE OR ITEM FEE �+IR HANDLING UNIT- QF.M. <br /> WATER CLOSETITOILET) g INCINERATOH � . <br /> BATHTU� <br /> IAVATORY (WASH �ASIN) � <br /> SHOWER <br /> KI�fCHEN SINK& DISP. SU�TOTA�. 5 � <br /> DISHWqSHER PEFMIT 5 T <br /> �AUNDflY 'RAV <br /> CLOTHES WASHEH TOTAL FEE 5 � <br /> WATER HEATER THIS PEfiM1T �ECOMES NVLL AND VOID �F WORK OR CONSTRUG <br /> TION AUTHORIZ[D IS NOT COPAMENCEO WITNIN 720 DAVS, OF IF <br /> URINAL CONSTRUCTION OR WORK IS SUSP[NDED 019 A[3ANOCNED FOR A <br /> DRINKING FOUNTAW P[RIOD OF 120 DAVS AT ANV TIM[ AFTER WORK IS COMMENCED. � <br /> fLOOR-S�NK Oq DRAIN ' HERE9V CERTIFV THAT I HAVE READ AND E%AMINED THIS AP� ' <br /> VACUUM OREAKERS —� PLICATION l�ND KNOW TME SAIdE TO�E TRUE l�ND CORRECT. A�L ' <br /> ROOF ORAINS-RAIN�EAOERS Pf70VI510N5 OF LAWS AND ORDINANCGS GOVERNING THIS TVPE <br /> - OF WOFiK WILL F3E COh1PLIED WITH l4'HETHER SPEf.IFIED HEREIN <br /> SIN (SERVICE-6AR, ETC.1 OR NOT, THE GRANTING OF A PERMIT OOES NOT PRESUME TO <br /> GIVE l�UTIiORITV TO VIOIATE OR C�INCGL THE PqOVISIONS OF <br /> — I�NV OTHGR STATE OR �OCAL LAW R@GULATING CONSTPUCTION <br /> OR YHE PERFORMANCE OF CONSTRUCTION. <br /> SUBTOTAL <br /> PERMIT S <br /> TOTALFE[ $ <br /> X <br /> SIGNATUPEOPCONTRACTOliORAUTH.AGENT DA [ <br /> SIDE YARD SET�ACK STREET SET[3ACK REAR VAftOS[T�AC PLAN CHECK NUMBEN PLAN CHECK FEE <br /> FE[ FiECEIPT NO. <br /> USE ZONE LOT AREA VACl�NT SITE <br /> ❑vE5 ❑No FEES VALl7ATIOV FEE <br /> TVFE OF CONST. OCCUPANCV GFiOUP NO.OF DWELLING T-- <br /> UNITS � <br /> 512E OF �LOG. NO. OF STORIES MAx.pCQ LOAD BUILOING 5 � <br /> I <br /> �LUMUING <br /> FIRE .'')NE DASEMENT FIR[SPFINKLERS <br /> REOUIRED <br /> ❑YES ❑NO MECHAPJICAL � <br /> SPECIGL CUNDITIONS: OTNER I <br /> 1 <br /> — PENELTY SEC. 3031a1 I <br /> _ i <br /> TOTAL 5� <br /> PERMIT V ALIDATION <br /> — WHEN PROPER�Y VALIDATED(IN THIS SPACE) THIS IS VOUR PERAIIT <br /> I AMLICN�OIIACClPT[OOY: Pl/�NSCNCIXI:pliv ACPROVCpfOHI5511l�NCEPY. <br /> � � .7 <br /> I <br /> � <br /> � <br />