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OF <br />• CITY<1 <br />%aviva I rrCJ%. I, Iviv <br />C. <br />everctt <br />+ <br />.� <br />PERMI Y <br />+ <br />everett <br />0�' <br />CITY IIAI I V0.1141, <br />EVuu 1I, OVA o❑nH <br />COMBINATION <br />`/ <br />BUILDING MECIIANIC AL • <br />PLUMBING <br />L it <br />:�((I�I1-7_inl�:._.g5m2-i�1? _;��rt>-iC�o& <br />ARCIRYLCT DESIGNER MA UR IL ADOIW4, IHUNE UCf NHLNI <br />`1 l'y� / _ /a - 3 iIG� •)JUP.RLL LIf�lTN wA.. `fOZ Lo._ 37-1-12.40 <br />GCNLNAL CUN T RACT OFF MAII. ACIUFik.SS PHONE LICENSLN( <br />'�- <br />MECIIANICALCONTf1ACroot MAIL ADDRESS PHONE LICENSL NC <br />i1.UM01WGCJNl HACTOfI MAIL AU1) RESS PHONE LICENSE NO <br />KCOMOINATION <br />❑0UILDING ❑PLUMPING ❑MECHANICAL <br />ANFW ❑ADDII W!+ ❑nLl CflATI(1N ❑RCPNR <br />VALUATION Uf WORK -- ---------•------- <br />= 1 U Oho- - - ❑OEMULISH ❑FENCE ❑SIGN ❑5YIIMh1ING Pr00L <br />DESCRIBE WORK. <br />6-JNJ.E.., l 01--W A- LI IJ rT AA U L_'T I Z`L6 FAM I L <br />FAnvOSLD USE <br />y MECHANICAL <br />LEGAL9ESCR`M/, 11 F OPERTY.LLIIJ Ii TYPF Of ENERGY <br />FOUR ci CSCRIPTION OF PROPERTY (SHOW BELOWUR nT/ACH ❑GAS ❑ELF.C. <br />FOUR CV °TEST _ <br />LOT 12 Lges TNT IJ a•751 NO.! TYPE OF EQUIPMENT _FEE <br />LOT BLOCK_OF _ - - - -- -II <br />1 NR CDHD. UNIT_5-ILP. CA. - 1 S_ � 1 <br />I E F --T <br />REI'IH�ILRATINN UNITS ILP. EA. <br />of TNC G Li k.LL o� L-OT 13 V?u< BZI --._I..-'--'-- ----_.-..-..----- ----J <br />n0 LER!; H.P. F.A. I <br />... -Z�^S I FORCED AIR SYSTL/.15- H. LU. MFn <br />F-A C ofVT 1' D I v A. J- i ------------- 1 <br />JOB ADDRESS I S--T <br />/'� ` , ( .,PACE F WA_L L_HE ATERS - N. T,U 1 <br />`I fl Wplo=- 1-C9Q.. /JV� — TL NIT f_EATER: H.T.U. <br />�FVAPORAT IVE COOL EI!. _? <br />PLUMBING R: s tinyHr,N <br />nr L <br />VENTILATION FA <br />�FIr.LpnAN f IIt1HD__ <br />NO. I TYPE OF FI%TURF. OR ITEM ifEE -! A111 Hr AR11 <br />BATH TLiCS -- S ___ __ _ __. _.._-- ---_—. <br />CLOT HFS N!ASHEF 1 1� _.. - <br />-� WATER HEATER 1 <br />DISH WASH:$RS Io - -I- - " -- ------ ------ <br />ORIN_P.ING FOUNTAIN:' I -_ - FA G.•HQ ILT FIR EPL A_CE Y. CHIMNEY -_ —_ I <br />'�--- OA_:. SYSTEM: NO OP OUTLETS <br />— --T <br />FIOOR DRAINS I <br />�cr—l—c nTvan — ____ _—...—SUO TOTAL S. d.dl <br />TOTAL. FEE < <br />Till i PERMIT L'CCWT(i NUI L l.NO V010 IF WORK OR CONSTRUC <br />TION AUTIIORIZCO IS NOT COMMENCED WITHIN 170 DAYS, OR IF <br />C DESTRUCTION OR WDPK IS SurrOINOCD OP AVANOONEO FOR A <br />PERIOD OF 170 DAYS AT ANY 111.1E AFTER WORK 15 CUMMLNCED. <br />1 HCREISY CF RTIFY THAT I HAVE READ AND EXAMINED THIS AP. <br />PI .I CAT IN AND K.P.OW T'IIF SAME TO BE TRUE AND CORRLCT, ALL <br />PROVISIONS Of LAWS AND ORDINANCES GOVE FINING THIS TYPE <br />OF WORK. CIIL.L BE COMPI ILO \PITH WHEl,ICR SPFCIFILD HEREIN <br />OR NOT, 111E GRAJ+TING OF A PFRVIT DOES NOT PRE'^LIME TO <br />GIVE AU1'IIORITY TO VIOLATE OR CANCEL. T'HE PROVISIONS OF <br />ANY OTHLR GTATE OR LOCAL LAW REBUT ATING CONSTRUCTION <br />OR 7RF. PERT ORMANCE OP CONSI RUCTION <br />TER SERV ICE SIZE__ BLOC,. SUPPLY FIZE <br />SIGNATURE OF CONT. <br />IE YARD SE I BACK <br />Si FIELT SETBACK <br />HEAR YARD SE TRACK <br />PLAN CHI CK.NUMBER <br />Z:E; Ir7 <br />Zog=T <br />Z(D;r <br />6 j %7 <br />E ZONE <br />3 <br />LOT AREA <br />�5 IC3)4.77,+S <br />VACANT SITE <br />544ES L]NO <br />FEES <br />'PE OF CONS'1. <br />OCCUPANCY GROUP <br />NO. OF DWELLING <br />UNI1S <br />ZE OF CLOG. ( NO. OF SSTTORIES <br />MAX. OCC. LO U <br />6o <br />/ LLRS <br />EOZO E <br />BASI RENT <br />F IHE�II <br />3 <br />D <br />FIEOUIREO <br />❑YES QI++6 <br />ECIAL CONDITIONS. <br />ACTOR ORAUTO. ACE NIT nTL <br />PLAN CHECK I EE <br />FEE L 0 RECEIPT NO. <br />_ i8F� s%�y9 / <br />VALUATION FEE <br />BUILDING <br />S�O�L�E J''3F <br />29DI00 <br />—'j <br />PLUMBING <br />IUr 0 <br />tJ <br />MECHANICAL <br />OTHER <br />TOTALI .• PENALTY EC ]B] 1.1 U n! v O <br />PERMIT VALIDATION <br />W FE N 1`1301.1 PLY V AL (DATE 11 TIN THIS SPACCI THIS Is YOUR PERh11T <br />