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� <br />� <br /> � Nr� c�:,,r�„��r:�; <br /> , <br /> ���r ��� COIVSTRUCI'ION ever,.,�t ,' <br /> everett PERMIT � <br /> biY HALL ]598AA5 I <br /> EVENEi1.M1A5NINGiON <br />' 98d01 I <br /> °"' °�E�E;a;MF„, BUILDING MECHAi`JICAL PLUI',�dfNG <br /> 01YNER MAIL ADDRE59 ZIP PHONE <br /> ,3u:.� .i�e-,t! i'�Lt LYt�ro�;f �ti�x> : "I�,R�{s3� t� �::z*z*.�, ;�7'_:�a I <br /> AFCHITECTOqDE51GNER MAILAODRE55 PHONE �ICENSENO. �� � <br /> I <br /> GENEPALCONTRACTOR MAILA�DRESS PHONE LICENSENO. <br /> t k1'lS��ieEt �ll: Ptt�2.�iC ?r'� "AlX:' <br /> MECHAN�CALCONTRACTOF MAILADDFESS PHONE LICENSENO. I <br /> � <br /> PLUMBING CONTRACTOR MAIL AOORE55 PHONE LICENSE NO. � I <br /> W <br /> m <br /> PERMIT CLASS OF WORK ? � <br /> j z <br />. �JBUILDING � PLUMeING �MECHANICAL <br /> ❑NEK' ❑ADDITION ❑ALTERATION ❑REPAIq ~ <br /> _ � <br /> VALUATION OF WORK <br /> 5 �DEMOLI511 ❑FENCE ❑SIGN ❑SWIMMING POOL W <br /> a <br /> OESCRIBE WORK - <br />'. �s�is�x �i�o . c: s5t� �a7 °�•.�� .�. ��� 2278 <br /> PHOPOSED USE <br /> MECHANICAL <br />� TYPE OF FUEI_ �OIL �Nl�T'. ��LPG. �ELEC. <br /> LEGAL OESCRIPTION OP PROPEFTY (SHOW BELOW OR A?TACH GAS <br /> FOUP COPIESI <br /> NO. TYPE OF E�UIPMENT FEE <br /> r L�—�Y���'F�� � � 4. , AIR COND. UNI f5-H.P. EA. � $ 1 <br /> I 'YR_ � � � M�+�. � Mlrs �.�'p_ 4�a4 REFRIGERl�Tlpp! UNITS--H.P. EA. <br /> J�•� ...1W8 a:iili{6 w A7fV <br /> �' . .f BOILERS--II.P. [A. � <br /> - C'�� � �" �� " GAS FIF,EO A.G VNITS��TONNAGE EA. <br /> __ FORCED AIR SYSTEMS-B.T.U. M EA. 1 <br /> JOB AODRE55y� WALL HEATEFS-�.T.V. M <br /> ���� 3.�Y1� ��� UNIT FIEMER$-6.T.U. M I <br /> EVt1PORATIVE COOLERS <br /> FLUMBING CLOTHES DRYERS � <br /> VENTILATION FAN <br /> flANGEHOOD � <br /> NO. 7YPE OF FIXTURE OR ITEM FEE A�R HANDLING UNIT- C.F.M. <br /> WATER CLOSETfTOILET) 5 INCINERATOR � <br /> OATHTUB <br /> LAVATORV (WASH�ASIN) � <br /> SHOWER � <br /> KITCHEN SINK& OISP. SV�TOTAL 5 � <br /> I ❑ISHWASHER <br /> - PERMIT 5 <br /> LAUNDRYTRAV <br /> CLOTHESWASHER TOTALFEE S I <br /> WATER HEATER THIS PERMIT BECOMES NVLL AND VOID IF WORK GR CONSTRUG <br /> TION AUTHORIZED IS NOT COMfvIENCED WITHIN 120 DAVS, OR IF <br /> URINAL t CONSTfiUCTIOIJ OR WORK IS SVSP[NOED OR A[5�1NDONEO POq H <br /> �RINKING FOUN'�qIN PEFIOD OF 120 DAVS M t1NV TIME AFTER WO(1K IS COMMENCEO. <br /> FLOOR-SINK Oft DRAIN I HEHEAY CERTIFV THAT 1 HAVE FEAD 11ND E%AMINED THIS AP� <br /> VACUUM 6REAKERS PLICATION AN� KNOW TNE SAME TO �E TRUE AND CORRECT. ALL <br /> ROOF ORAINS-RAINLEAUERS PROVISIONS OF LAWS AND ONDINANCES GOVEFNING TIi15 TVPE <br /> OF WORK LVILL �E COhiFLIED WITI�1 WHETHEq SPECIFIED HEFE�N I <br /> SINK (SERVICE-DAR, ETC.) OF NOT, THE GFIANTING OF A PEFMIT DOE,". NOT PftESUME TO <br /> GIVE AUTHORITY TO VIOLATE OF CANCEL THE PROViSI/�NS O� � <br /> � ANY OTHER STATE OR LOCAL LAW qEGULATING CONSTRUCTION I <br /> OR THE PEfiFOFMANCE OF CONSTRUCTION. <br /> I SU9 TOTAL <br /> PERMIT 5 <br /> ITOTAL FEE 5 ���'�+ I <br /> x r <br /> SIGNATUREOFCO'ITRACTOftORAVTFI.AG[NT DATE <br /> SI�EYARDSETBACK STREETSETUACK FiEARYARDSETAACKPLANCHECKNUM�EF PLANCHECKFEE <br /> FEE RECEIPT NO. <br /> USE 20NE LOT AflEA VACANT SITE <br /> ❑YES ❑No FEES VAIUATION FEE � <br /> TVPEOFWNST. OCCUPANCVGf10UP NO.OFOWLLLING i <br /> UNITS � <br /> SIZE Of BLDG. NO.Of STORI£5 MAX. OCQ LOAD BUILOING 5 , ,�� ,�}L � <br /> FIfiE 20NC BASEMENT FIFESPqINKLEFS NLUM�ING i <br /> r'.f�U1REO � <br /> LYES ❑NO MECHANICAL � <br /> SPECII�L CONDITIONS: OTHEN � <br /> I <br /> i — PENELTV — SEC. 3031a1 I <br /> I TOTAL � <br /> r�� ^s�e <br /> PERMIT VALIDATION <br /> WHEN PROPERLV VALIOATEO UN T{IIS SPACE` TFIIS IS VOUR PERMIT <br /> APPLICAilOYACCEPiEDBY: Pl4NSCNECNEDBV: ACVFOVE�RISSII�NCEtlT. <br /> ' <br /> � Q <br />