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� fAc Evcrgreeu I' <br /> ��T,- o� CONSTRIJCTION e•�ere�t ' <br /> ev�re�� PER��IT <br /> „�� �,��:.,_ �:�.;��., i <br /> � ��� , °� �°.�.�°�':���° BUILC)ING MECHAfJICAL PLUMBING <br /> �,�,<<��•:��� <br /> OWNER MFILADDRESS ZIP PHpNE <br /> J `i:l .. ':TP::?I � C '; ��1`'i2'74 1`�:��i s <br /> ARCH�TECTORDESIGNER MMLADDiiE55 PHONE LICENSENO. <br /> GENERAL CONTF",CTOR MAIL A�DRE55 PHONE IICENSE NO. <br /> ���L� ^ F"".� a90(f3"�..� ;i �r°'. 337.�'z�9 <br /> MECHANICAL CONTRACTOR MNL ADDRESS PHONE LICENSE NO. <br /> ts�'c <br /> PLUMBING CONTRACTOR MAIL AODRESS PHONE LICENSE NO. � <br /> W <br /> .. .�S � <br /> PERMIT CLASS OF WORK � <br /> }' �t, '�e z <br /> U. pUILDING �aJPLUM0ING [pA1ECMANICAL �NEW ❑ADDITION ❑ALTERATION ❑PEPAIR ~ <br /> � <br /> VALUATION OF WORK � <br /> S f-MtY1 � �]OEMOLISH ❑F[NCL ❑SIGN ❑SWIMMiNG POOL a <br /> 4Zv��.�� <br /> DESCRIO[WORK �^�� <br /> •-^a^.,.- ..,�... .. ���.. .�...t : `e... ai <br /> l�:'.:��. . . L(�... . _:.��.. _.. u_�_..�: V <br /> PROPOSEO VSE MECHANICAL <br /> L@Gl�L DESCRIPTION OF PROPEfiTY ISHOW�ELOW OR /�TTACH TYP[ OP PUEiI. �n�L ❑GAS ❑LPG. �ELEQ I <br /> FOUR C,pP�ESl� `c�� �.-T� ^T�� � NO. TYPE OF E�UIPMENT FEE <br /> LOT }� � LOCK— F— _ ��---- <br /> AIR CCND. UNITS- H.P. EA. $ I <br /> NEFfi1GERATION UNITS--H.P. E!� <br /> DOILEFS--H.P. LA. I <br /> GAS FIPED t1.C. UNITS-TONNAGE EA. <br /> , FORCED AIFi SYSTEMS-�.T.U. M EA. I- I <br /> JOEI ADDRL55 •�i �i;' ��-r{ . � ^ �VALL HEATERS-U.T.U. M <br /> � UNIT HEATERS-�.T.U. M I <br /> EVAPORATNE CODLERS I <br /> PLUMBING CLOTHES OIiYERS I <br /> VENTILAT�ONFP' <br /> RANGEHCOD I <br /> N . iVPE OF FIX7URE OR ITEM FEE �11R MANOLING 1 ,T- C.F.M. <br /> WTTEP CLOSETITOILETI $ INCIN[FATOR I <br /> pATHTUB - <br /> LAVATORV(WASH BASIN) I I <br /> SHONEii --_—i— i <br /> � KITCNEN SINK F DISP. SU6 TOTAL 5 � �y <br /> DISHWASHER PERMIT 5 � <br /> e�-.� I <br /> LAUNDFVTRAV iOTALF[E $ L! �� <br /> � CLOTHES Wl�SHER TM�S PERMIT DECOMES NULL AND VOIp IF WOFK OR CUNSTRUG <br /> WATER HL�ITEP TION AUTHORIZED iS NOT COMMENCED WITHIN 12U p�\'S, OR il' <br /> UflINAL CONSTRUCTION OR WORI: IS SUSPENDED Ofi A�AN�ONEp FOFi A <br /> �RINKING FOUNTAIN PERIOD OP 120 DAVS AT ANY �IA1E AFTER WOPK IS COMMENCE0. I <br /> FLOOR-SINK Ofl DFAIN I HEREpV CERTFY THAT I HAVi REAn ANO 8s/�MINfD THIS ��* I <br /> VACUUM AR[AKEFS PLICATiON ANO KNOW THE SnME TO O[ ��RUE AND CORfiECT. nlL <br /> ROOF ORAINS-PAINLEADERS �-- PAOVISIONS OF I.AWS AND ORDINANCES GOVERNING THIS TVPE <br /> OF WORK IYI�L DE CONPLIE�WITH WHETHER SPECIFILD 11[HEIN <br /> SINK ISEiiVICE-UAR, ETC.1 —r OF NOT, THE GRANTING OF A PERMIT DO[S NOT PRESUME TO <br /> --I - GIVL AUTHORITV TO VIOLME OR CANCEL TME PROVISIONS OF <br /> I1NY p�HEfi STATE OR LOCAL LAW REGULATINGCONSTRUCTION <br /> OH THE PEfiFORM1tANCE OF CONSTRVCTION. <br /> SUE3 TOTAL <br /> PEHMIT S � <br /> TOTALFEE 5 ��� <br /> __— 1—_ �Yllafl, <br /> X .Y7 /4 <br /> SIGNA'UHEI.fCONTRACTONORAUTH.AGGNT OAT[ <br /> SIDEVf`AROSET�ACK STRE[=�€TpACK R[ARYa$f�5[T(3ACKPLANCHECANUM1t(3@P PLANCHECKFfLgE�.�p <br /> u� l 6lli .��f�Si. FEE t�('�' RECqIV(:7 <br /> 11 <br /> USEZONE.�� LOl AFEA VA,yCl�NTSITF — <br /> �,JvES ❑No FEES VALUA710N FEE <br /> TVP[OF CONST. OCCUPANCV GROUP NO.OF OWEI�ING <br /> UNITS .L � <br /> SILE OF �LDG. NO.UF STORIES MA%.OCQ LOAD AUILDING 5 � �� <br /> I <br /> � <br /> PLUM�ING I � I <br /> FIRE NE IlASEMENT�y�p �IiiESPRINKLERS <br /> � Yw R OVESED �NO MECHA�JICAL �� � I <br /> SPECIALCONDITIONS. OTHER � <br /> I <br /> � <br /> _ PENF�Tv SEC. �031a1 i <br /> TOiAL j.�.7 � H <br /> PEHMIT VHLIDATION <br /> WH[N PqOi'[RLY' VALIOATED(IN TNIS SPACEI THIS IS YOUR PiR�11T <br /> FPI'LlCnliO':nfCfPlfPlrv PIM1N`[PI�CCOIdV MPNOV[Uf0/1 6`.UAOC[f1V <br /> ('P.1 c.�.' 11K.' <br /> 0 <br />