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r''c``�7Y`'°° �� ;ONSTRUCTI�O�" <br />everett PERMIT PERMIT N0. 119g� <br />CITY MALL 259-B7a5 <br />EVE9ETT,VJA9B201 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL � PLUMBING <br />(. OWNER MAILApUHESS CITY ZIP PHONE <br />� Dixon Uahl <br />ARGHITECT OP OESILf:CR MAIL ACOflE55 GI7Y ZIP PHONE <br />GENERAL CONIRACTOR MAIL AODHE55 GITY ZIP PHONE LICENSE / <br />MECMFNICAL CONiRACTOR MAIL AOOPE55 CITY ZIP PHONE UCENSE N <br />PLUMBING CONTRACTOR MAIL ADDRE55 CIiY ZIP PHONE LICENSE M <br />� Robinson Plumbinq 607 S.E. Everett Ma>> t�ay� Fverett- 9A 04 355-6171 <br />CLASSOFWOPK j� BINP272C2 <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN Ll WOOD S70VEIFIREPLACE INSERT <br />f <br />DESGRIDE \YORK <br />LOT_OLOCK_OF <br />JOB AODRE55 <br />2939 Nassau <br />PLUMBING <br />10. TYPE OF FI%TU <br />j WATERCLOSETITOILET) <br />1 BATHTUB <br />LAVATORV�WASHBASIN) <br />SHOWER <br />1 KITCHEN SINK & DISP. <br />LAUNDRYTRAV <br />CLOTHES WASMER <br />WA7ER HEATER <br />URINAL <br />ORINHING FOUNTAIN <br />FLOOR ORAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINLEADERS <br />SINK ISERVICE — BAR, ET0.1 <br />TO7AL <br />TOTAL FEE <br />SIZE OF BL�G. I NO. OF STOFIES <br />1. ENVIRONMENTAL CMECK UST <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />a. FIRE PROTECTION SYS7EM <br />5. GRAOING <br />6. DRAINAGE <br />7.ENVIRONMENTA�IMPACTSTA7 <br />B. HEALTH DISTRICT <br />APPLICATION ACC. BY PLAI <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />OPATfACHFOURCOPIES� APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STPTE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNATl1flE OF CONTRPCTOR OR AUTMORIZED AGENT DATE <br />MECHANICAL <br />N0. TYPE OF E�UIPMENT <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FOFCED AIR SYSTEMS — B.T.U. M EA. <br />WALL HEATERS — B.T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORA7IVE COOLERS <br />CLOTHES DRVERS <br />VENTILAiION 7AN <br />RANGEHOOD <br />AIR HANDLING UNIT — QF.M. <br />STOVE — WOOD <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />i <br />5 3 00 <br />s 11 00 <br />REFR YARD SETBACK PLAN CHECK <br />VACANT SITE <br />YES . NO F <br />NO. OF DWELLING UNITS <br />BUILDING <br />MA%.00Q IOAD <br />PLUAIBING <br />FIRE SPRINKLERS MECHANICAL <br />REOUIRED <br />VES NO <br />.,.. ...�� OTHER <br />BY IAPPR.FORISSUANCE BY <br />SUB TOTAL f <br />PERMI7 S <br />TO7AL FEE 5 <br />PLA�I CI <br />FEE <br />VALUAiION <br />IS <br />FEE <br />RECEIPT N0. <br />FEE <br />PENAL7V SECV307�a� <br />TOTAL S ]. O O <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN TMI$`.tP�CBI THIS�SBO�1f�P�1l�T—� <br />_ . j ': . . . -. �i�i <br />YQU� RECFIPT� <br />r�-�n�K You <br />ADDR[�S '. 1L[ <br />I1�Y83 <br />� <br />� 1 <br />�� <br />J <br />� <br />