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thc Foe�gr��en <br /> ���� �, CONSTRUCTION �verett <br /> everett PERMII <br /> tilv HnLL 159AB:b <br /> tvtx[n.wasmxm dv <br /> ��.ni <br /> "" °` `°`"�"", BUILDING MECHANICAL PLUM6ING <br /> o�n.orac•u <br /> OWNER MAIL ADON[SS ZIP p��pryE <br /> C.°.. �Q�g�n 1R? i� �:'�ol 2� 663d <br /> ARCMP.ECTOROFSIGNkR MAILApDRE55 PHONE LICLNSENO. �� <br /> GENERAL CONTRACTOR MML ADORE55 PNONE LIC[NSE NO. <br /> �� <br /> MECH4NICALCONTiiACt09 MqILA00RESS PHONE LICENSENO. <br /> PLUMBING CONTRl�CTOR MAIL ApD;f55 PHONE �ICENSE NO. W <br /> m <br /> PERMIT CLA55 OF WOfiK j <br /> �BUILOING �PLUMpING �M[CHI�NICA� Z <br /> �NEW ❑AOOITION ❑ALTERATION ❑li[PNH ~ <br /> � <br /> VALVATION OF WORK � <br /> S � ❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING FOOI. W . <br /> a <br /> OESCRI6f.WORK <br /> � ew� 1317 <br /> PROPOSEO UGE <br /> MECHANICAL <br /> ivvE OF FUEL �OIL �NAT. QLPG. �EIEC. <br /> LEGAL OESCRIPTION yOP PROPEIiTV ISHOW[3[LOW Ofi ATTACH GAS <br /> �or�ES��ocK}�oF p�� t� L NO. _ _ TVPE OF EOUIPMENT FEE <br /> AIR COND. UNITS-H.P. EA. S I <br /> REFRIG[RATION UNIiS-H.P. EA. <br /> ❑OILEfiS-H.P. GA. � <br /> Gl�51'IfiEO A.C. UNITS-TONNAGE EA. <br /> FORCED AIR SVSTEMS-O.T.U. M EA. � <br /> JOB AD�AE^ _ � WlLLL HEqT[qS-13.i.U. M <br /> �fN <br /> UNITH[MEH$-�.T.U. M � � <br /> [VAVOfiATNE COOLEFS <br /> PLUMBING c�oTNes oarer�s � <br /> VflNTILATION FAN <br /> RANGEMOOD � <br /> NO. TYPE OF FIX7URE OR ITEM FEE nIR HANDLING V NIT— QF.M. <br /> WATERCLOSETITO�LET) § T INCINERATOR � <br /> �ATHTUB <br /> LnVATORYIWASM BASINI � <br /> SHOWLR <br /> KITCNEN SINK R DISP. SVB TOTAL 5 <br /> I <br /> OISHWASHFR � PEIiM111T £ <br /> LAUNDqY TRAY � <br /> CLOTNES WASNER TOTA�FEE 4 � <br /> THIS PERMIT �[COMES NULL AND VOID IF WORK OR CONSTRUG <br /> WATER MEATER TION AUTHORIZEC IS NOT COMMENCED IVITHIN 110 Dl�VS, OR IF <br /> URINAL CONSTRUCTION OR WOPK IS SUSPENDEU OR f�(3ANOONED FOR <. <br /> �RINKING FOUNTMN PEll00 OF 120 pAVS AT ANV TIME AFTEH WORK IS COMMENCEO. <br /> FLOOR--SINK OR UIiAIN I HEREf1V CERTIFV THAT I HAVE qEAO l�NO [%AMINED iH15 AP- <br /> VACUUM pREAKERS �LICATION AN� KNOW TMF SAh1E TO [tE THUE AND CORIiECT. !LLL <br /> ROOF DRAINS-RAINlEADEFS PFOVISIONS OF LAWS I1ND OPOINANCFS GOV[RNING TIIIS TVPL <br /> OF WORK WILL (3E COM1IPV[D \VITH WHETHEfi SPECIFILD H[REIN <br /> SINK (SERVICE-BAR, [TC.) OR NO'�. THE GpANT�NG OF A PERMiT OOES NOT PRESUME TO <br /> GNE l.JTHORITY TO VIOLATE OR CANf.[L TME PqOVISiONS Of- <br /> ANY Ol'HER STATL UR LOCAL lAW qEGULATING CONSTRUCTION <br /> ORTHEPERFORMANCEOFCONSTRUCTION. <br /> SU�TOTAI. <br /> PERRAIT 5 --T— <br /> TOTAL FEE _ S _� `l `_ <br /> X �7���7 <br /> SIGNATVR[OFCUNTRACTOqOR/�UTH.l�GENt OATE <br /> 510[ YAqpS[TpACK STflEETSET�ACK REARYARUSFTOACKPLANCHECKNUAtE3tR PLANCHECKPE[ <br /> � FEE � IlE(',�uj [JD. <br /> USE ZON[ LOT AR[A VACANT SITE <br /> ���M j <br /> []vEs ❑rvo FEES VALUATION F[E <br /> TVPE OF CONST. OCCVPANCV GROUP NO.Of pWELLING <br /> UNITS � <br /> S�ZE OF I3LDG. NO.OF SIORIES MA%.00G LOAU 9UILDING $ KI � yy <br /> _— _y <br /> PLUMOING I <br /> 19RE20NE [3A5[M1itNT FINESPfi1NKLERS <br /> REOUIRED <br /> ❑YE$ ❑NO MECHANICAL � <br /> SPECIAL CONDITIONS'. OTHER � <br /> - I <br /> - — PENELTV SEC.30310) I <br /> TOTAL � �'J <br /> PERMIT VALIDATION <br /> WHEN VROP[fil.Y VALIOATED I�N TH155�'nCEI T1115IS VOUfl PLRDAIT <br /> � <br /> �PPLiC�i10ypCffPif�FlY n�pN5C11ECKlf1p� pVCPOVt��O(VI':Vn,ryfFPY. ' <br /> "•:'. �.c. e.r,. <br /> ;� <br />