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; <br />����� � � � �r� CONSTR UCTION <br />"" "' 'r'FRMIT <br />evE r�tt <br />CIT\' N1LL.ClIN),IS <br />i-vcaFi i, wn ,�+�o, COMBINATION + BUILDISJG • MECHANICAL • PLUMBING <br />01VNFli p1A11. AIJDkLSG 211' PIION6 <br />Fr.ank Lupin 4001 Rucker <br />--_.._.___.. ..------------ ------- <br />ARCHIiI'.C1.)HIlfl;i�i;Nf.li AlqlI.AUDItL:;S PHONL LICGNSk <br />4ENLRALCONTRI�CTOR MAI�ApUHE55 PNONE LICENSE <br />At6ClIANICALCONiRACTOR MA�LAODq[55 PIIONE lIC[NSE <br />Natural Gas Equipment <br />PLUMBING CONIf�ACTUH MAIL A�DRESS PI{pNE I Ic�NSF <br />❑con+aiNnTioN <br />❑ �UILDING ❑ PLUM131NG �M1IECHANICAL <br />❑NEW ❑AUDITION ❑ALTERATIUN ❑R6Pl�lfi <br />VALUATION OF LVORK <br />5 ❑OFMOLISN ❑FCNC[ ❑SIGN ❑SWIMMING POOI. <br />DESCFI�@ N'JRK <br />RT <br />LOT ❑LOCK_ <br />4001 Rucker <br />PLUMBING <br />everett <br />•� <br />J) <br />l'.) <br />V.J <br />MECHANICAL <br />I3ELOW OR ATTACH TVPE Of CNFRGY -- <br />❑GAS ❑ELEC. <br />NO. �VPE OF E�UIPMENT FEE <br />AIR CONU. UNITS-H.P. EA. 5 1 <br />PCfRIGEFATIONUNITS N.P.EA. �- <br />_ _ l <br />f30�LERS H.�'. [�. I <br />FORCED AIR SVSTEMS-d.T.U. MEA. <br />_ ___ - I <br />SPACL A. WALL MEATEFS - A.T.V. � <br />i UMT II6ATLIiS 13.1.U. I <br />-f CVAPOIiAIIVGCOOLEflS <br />(CIOTHCSDRYERS I <br />V[NTII.�TION FAN T <br />�� liANGE HUOU���' I � <br />_ FEE nIH Hn!iDUNG UNI1 _ C.F.M. � <br />S — _ _ � <br />-- 1 1 WATER NEATf.R �...-' — 2 OTO <br />-- FAC. IIUILT PIRFPIf�C[ R CHIMNEV I <br />I <br />i GAS_SVSTGIA� NO OP OUTLETS __�_ <br />--i _ _ _ _ ._ _ SVUTOTAL 5 Z I OO <br />— - � __."_ _ . ..-_._ PEH�dIT 5 3 �0 <br />� TOT(1L FEE 5 I <br />—� T1115 PLl�M!1 ❑[COMES NVL1. �1Nt) VOID IP WOPK OR CONSTRUG <br />t10N f,Ui11OR121U IS NOT COMMENCGD WITHIN 120 DAYS, OR IF <br />CUNSI �VCTION OP� WONK IS :USPFND6D OH A6�NDONE� FOq A <br />----�- PEftIOD OP 120 DAV; AT ANY i1MG AFTBR WORK ISCOMMENCED. <br />—"'—j I NEfi[ItV f,EHTIF V THM I �IAVE PEAD ANf] E%AMW[U TIIIS 11P� <br />FLIC�T'ON ANU KNOW 1HII S/1M[ 101tB TPUE �NDCOflHECT. ALL <br />__ � VRpVI::iON; OI LAW; l�NO OIiDIN4NCC5 GOVEHNW i THIS TVPE <br />i OI' WOH`C WILL 6[ COM�'LiGO WITH WH[THER SPECIFIED HERtIN <br />-- OH NOT, tllF GRnN1iNG OI' A VERMIT OOES NOT PRESUMI TO <br />i GIVf AU1110RITY 10 VIOLI�T@ Ofi CANCBL TMC PROVISIONS OF <br />ANY UTHEfi STAtL OR I.00AL lAW qEGULATING CONSTfiUCTION <br />� OII lll[ P[H.'ORMANC[ OF CONSTRUCtION. <br />PERMIT S _ _I .. 3�L��J <br />TOTAL FEE ��. ; � <br />X ., .� ,1:izz�_'" . <br />TEfl SE(:VICE 512E ULD6. SUPPIv SIZE �S�arvnluli[bf ¢aNrRncro�voRnuln.nGLNr DnrE <br />IEYAPDnETUACK STREGTSGTIMCK RFIIRYAGDSLTO�CK1•L.�NCUlCKNUMfi@R I P�ANCHECKPE[ <br />FC[ �fi[f,E1PTN0. <br />SVECIAL CONUITIONS�. <br />l.GJPIIUNY I��IdM:OIIC✓IIIbY <br />LYES ❑NO � <br />VALUATION I FEE <br />Ml1%.00C. IAAU ❑UILDING 5 <br />PLUM(SING <br />Fliif til'HINKI[HS <br />R[UUIIlEU <br />❑VES ❑NO MCCIIANICAL <br />OiHLfi <br />1'I:NAI.TV '"-- tiEG:lO�la) <br />TOTAL ���-��--'�- -"� <br />e��mir vnuonnorv <br />WMFN 1•ROPGRI v VA1 iDATfD IIN 1H1., <br />: <br />$ I �� <br />I <br />I <br />_ 1 <br />__ __�- <br />$ � �� . <br />.,,��,:, ,,. ,, � ��„�,�A� <br />YOU R RECEIP`f�' <br />� THANK 1'i�l�� <br />� cn <br />- � �tt 79 : ,'; �. <br />. _ . _ . � .� _ _.� <br />