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� Un� FrerqrCCn <br /> I ���, �� CONSTRUCTION Qverett <br /> eve�ett PERMlT <br /> �,.,,,�, �� , <br /> ,�tv�„ ,,.,�.,��:,��,�, <br /> �w:,,� <br /> °"� °°�°^�M°�°� gUILDING MECHANICAL PLUMBING <br /> o�vuarM�xi <br /> OWN�Epq�� ��}�T /M�/(y�I'L ADOPES LIP rHO.�Ny��J� <br /> �.SI� Y: �INIV� IJJyy .ri� . . • ��r�J.��ai �. ���/ <br /> ARCHiTECT OR OESIGNER M1V�IL AODRE55 �HONE LICENSE NO. <br /> GENE{R!}ALCONTFACTOH MAILApDRESS �HONE LICENSENO. <br /> Ci�4pi <br /> MECHqNICALCONTftACTOR MAIL ADDRE55 PHONE l ICENSE NO. <br /> � <br /> PLUM!IING CONTRACTOR MAIL AOPRE55 �'MONL LICENSE NO. W <br /> m <br /> _ _—__-- _-- � <br /> PERMIT CLASS OF WORK � <br /> z <br /> �OUILDING ❑ PWMOING �MECHANICAL C ~ <br /> ❑New 'l7nnoinov ❑ni_1er�nnoN ❑r;�rnn� � <br /> VALUATION OF WORK � � <br /> �{�� ❑DEMOLISII ❑��CNCC ❑SGN ❑SN'iM11NWG POOL W <br /> S — — ---- — a <br /> oescaior.wo^c �r t,:�i'%.s '�'` L`.�_''" �)'.i1S ��1 <br /> rnoroseo us� MECHANICAL <br /> Tvvtor-Fuii. []oii. L�n:n�. �]ir�.—[Ji�ec. <br /> IEGAL DESCRIPTION OF PROPERTV (SMOW pELOW OR qTTACH �"��' <br /> f O V P COPI ES) <br /> LOT � OLOCK—oF �� �� _ NO._ TYPE OF E�UIPMENT FEE <br /> AIR COND. UNITS-M.P. EA. S I <br /> R[FRIGEFATION UNITS-H.P. EA. <br /> AOILERS-II.P. EA. � <br /> GAS FIPEO A.C.UNITS-TONNAGE EA. <br /> "_'_- _ _ _ _ -- <br /> POPCEO AIH SVSTEMS-B.T.U. M EA. I <br /> JOR AUORE55 ��N '.iq.�, tt�� WALL MEMERS-6.T.U. M <br /> ��l F UNIT HEATERS-O.T.V. M � <br /> EVAVOPATIVECOOLERS <br /> PLUMBING c�or��Es oaveas i <br /> — VENTILATIONFAN <br /> Rl�NGE HOOO � <br /> AIF HANOLING UNIT- 0.F.M, <br /> ��0. TYPE OF FI%TURE OH ITEM FEE INGNEfinTOR I <br /> Y!ATER CLOSE7ITOILETI 5 ,+_ — <br /> �ATHTUO <br /> LAVI�TONV(WASH DASIV) � <br /> —f' <br /> — ;HOWER <br /> KIi'CHI[NSIt1K& DISP. SUBTOTAL 5 I <br /> L)ISHWASHER PEAMIT 5 —_�— <br /> _ IAUNDfiV TRAV _ I TOTAL FEE S I <br /> CLOTHES WASH[R THIS PEFMIT pECOMES NULI AND VOIO IF WORK ON CONSTRUG <br /> WATER HEATER TION AUTHOf112ED IS NOT COAIMENCEO WITHIN 120 DAVS, Oq IF <br /> URIN/1L CONSTRUCT{ON OR WORK IS SUSPENC�ED ON ADANDONED FOR A <br /> PERIOD OF 120 DAVS AT ANV TIME .4FTER WOFlK IS COMMENCED. <br /> ORINRING �OUNTAIN <br /> FLOOfl-SINK O!i DRAIN I IIEfiEfiY CERTIFV TIIAT I IIAVE FEA� ANC EXAMih:ED THIS AY- <br /> Vl�CUUM,BREAKERS - P��CATION AN� KNOW TNF.SAA1E TO �E tFUE AN�CORFECT. ALL I <br /> ROOF DNAINS-P.nINLEAOERS_ — ��OVISIONS Of- LAlVS AND ORDWANCES GOVERNING TIIIS T1'PE II <br /> OF WORK WILL BE COMPUED WITH WHFTHLfi SV[UFIEO HENLIN <br /> SINK (SERVICE-DAR,ETC.1 OI�. NOT, TME GFiANTING OF A PEflMII' f1GES NOi PH@;U1d[ TO <br /> GNF AUTHOfi1TV TO VIOLME Ofl CANC[L 1HL i'RDt'i51pNs OF <br /> NNV OTHEF STATE OR LOCI�I LAW REQIiL�TING GUN�TRt1CTION <br /> OR THE PEFFORAtANCE OF CONSTRVCTIOfJ <br /> SUBTOTAL <br /> PEFMIT 5 <br /> TOTAL FEE 5 �'��M� <br /> x �� <br /> SIGNATURLOFCONTRACTOROfiAU?H �GENT Ui��[ <br /> :fll)F VARpSETUACK STREET SETUAC� REAR VAFOSET�ACK PLAN CHECK NUMDEF PLAN CHECK FEE <br /> F[E �iECEIPT NO. <br /> USE ZONE LOT AF[A V.1C�1NT SITE <br /> ❑VES ❑NO FEES VALUATION FEE <br /> TVPE OF WNST. OCCUPANCV GROUP NO.OF OWELLING � <br /> UNITS <br /> SIZE OF BLDG. NO.OF STORIES MA%.00C. LOl�D BUILOING S .LVVtI�w iVj� <br /> PLUMI3ING � <br /> �RIZONE �4SEMENT FIRESPRINKLERS � <br /> REQUIRED pqECNANICAL � I <br /> ❑VES ❑NO <br /> I <br /> SP[Ci/�L CONO�TIONS: OTHER � <br /> PENf:I.TV SEC.�03(al � <br /> —�— TOTAI I I <br /> � i <br /> PERMIT VALIDATION <br /> \YHGN FftUPF Rl Y VlLLIDAT[D IIN THIS SVACE)THIS 15 VOUR P[fiAilT <br /> -- I <br /> nlvtn�.+iiOLACCCPTE00� �4ANSC�ILIXCfJpY�. R�PqWCD��]IICSU>i1QlIY <br /> � Ze �• u� "• y C• <br /> � n � <br />