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the Evcr;�reen <br /> ���� oF �ONSTRU�TION everett <br /> �verett PERMIT <br /> cur�mit raeans <br /> cveacrr.wasau+cia�v <br /> aemi <br /> °�°� °°°°�.�M�����r BUILQING MECHAMCAL FI_UMBING <br /> ueveiocraexi <br /> OWNEfi Ml�ILADDRESS ZIP PHONE <br /> i!. 47. C'IGe�%.L'�:Y•t.`' .c�:��::11iP. .�.liC}3 3;r�:: 311..�i�I L7Z'•U jyr! %�>:r...77 <br /> ARCFIITECT OR DESIGNER NAIL ADDRE55 PHONE LICENSE NO. <br /> GENERALCONTFACTOR MlULAL��RE55 PHONE LICENSENO. <br /> MECNANICAL CONTFACTOR MAIL ADDPESS PHONE LIGENSE NO. <br /> � <br /> PLUMOWG CONTPACTUF MAIL ADDRESS PHONE LICENSE NO. w <br /> m <br /> � <br /> PEFMIT CLA55OF WORK � <br /> z <br /> � �VII.�ING � PLUMBING �MECHANICAL �NEW ❑ADDITION ❑ALTER�ITION [�REPAIfl ~ <br /> � <br /> VALUATION OF WORK � <br /> j^jV�G� ❑DEMOUSN ❑FENCE ❑SIGN ❑SWIMMING PUOL W <br /> s a <br /> DESCRIBE WORK <br /> r�pl��cc ;o.lastez wi�'a pluster ,�oarc $�`7S <br /> PROPOSED USE MECHANICAL <br /> TVVEOfFU[L �OIL ❑GAS ��PG. �ELEC. <br /> LFGAL DESCRIPTION OF PROYERTI' ISHOW eEI.OW OR ATTACH <br /> FOUii�apPl€$1 ��:�� ?,`JCr�i�r N0. TYPEOFE�UIPMEN7 FEE <br /> LOT flLOCK_OF qIR COND. UNITS-H.P. EA. 5 I <br /> _ REFR�.GEAATION UNITS-M.P. EA. <br /> pOILEFlS-H.P. EA. I <br /> GAS FIREU A.C. UNITS-TONNAGE EA. <br /> FORCED AIR S�STEMS-O.T.U. M EA. I <br /> JOB ADURESS WALL HEATERS-B.T.U. M <br /> I.J'.}.�J Z3T'.�. S�I�E�t UNIT HEATLflS-�.T.U. M � <br /> EVAPORATIVECOOLERS <br /> PLUMBING CLOTHESORVERS � I <br /> VENTILATION FAN <br /> flAYGEHOOD � <br /> AIR HANDLING UNIT- C.F.M. <br /> N0. TYPE OF FIXTURE OR ITEM FEE iNCINERnTOR I <br /> WATER CLOSC-T ITOILETI 5 <br /> pATHTVB — <br /> LAVATOPY (WASH BASIN) _ � <br /> SIiOWER <br /> KITCHEN SINK& DISP. SUB TO'!AL 5 � <br /> DISHWASHER 7ERM1T 5 <br /> LAUNORVI'ftAV TOTALFEE 5�_ I <br /> CLOTHES WASHEP THIS PERMIT 6ECOMES NULL AN� VDID IP WORK OR CONSTFUC� <br /> WATER HE�ITEF TION AI�THOFI2E� IS NOT COMMENCED WITHIN 120 DAVS, OR IF <br /> URINAL CONSTRUCTION OR WORK IS SUSPLNDED OR A�I�NDON[� FOR A <br /> DRINKING FOUNTAIN PEIaIOD OP 120 DAVS AT ANY TIME AFTEft WOFK IS COMMENCE�. <br /> FLOOR-SINK OR DflAIN I H[FEBY CEFlTIFY THAT I nAVE READ AND EXAMWED THIS l�P� <br /> VACUUM �REAKERS PLICATION AND KNOW THE SAME TO UG TRUE ANC GORHECi. ALI. <br /> PqOV1510N5 O� LAWS ANC ORDINANCES GOYERNING THIS Tt'PE <br /> ROOF ORAI4S-RAINLEAOERS OF- WOFK WILL 6E COMPLIED WITH WHETHEH SPECIFIED FIEREIN <br /> SINK ISERVICE--BAR, ETC.) ~ OR NOT, THE GRANTING OP A P@RMIT UOES NOT PRESUME TO <br /> --� GIVE AUTHOfiITY TO VIOLAiE OR CI�NCEL THL PROVISIONS Of- <br /> ANV OTHEfl STATE OR LUCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRVCT'ION. <br /> SUBTOTAL <br /> PERMIT S ,r, /74'77 <br /> TOTALFEE 5 � <br /> x <br /> SIGNATUREOFCONTFiL�CTORORAUTH.AGENT DATE <br /> SIOE YAHD SET6FCK STFEET SET(il�GK RFPR YARL'SET6.:CK PLAN CHECK NUM6EF PLAN CNECK FEE <br /> IFEE IRECEIPTNO. <br /> USE ZONE LOTl�flEA VACANT SITE — 1 <br /> �1 <br /> ❑vEs ❑No FtES VALUATION FEE <br /> TVPE OF CONST. OCCUPANCV GHOUP UNIOS DWELLING � <br /> �� <br /> SIZE OF BL�G. NO. OF STOftIES MAX.00Q LOAD �UILDIfJG 5 � � � ��� <br /> PLUM�ING � <br /> I�IIiEZONE 6ASEMENT FIRESPRINKLERS � <br /> REQUIflED � <br /> ❑YES L]NO MECHAflICAL I <br /> — I <br /> SPECIHLCONDIlIONS: OTHER � <br /> _ _ — i <br /> PENELTY SEC. 303fa1 � <br /> —_ _---"_ _ —_ .`.� ... <br /> TOTAL I <br /> PERMIT VALIDATiON <br /> WHEN V80PEiiLV �nLIO4THD (IN i111SSPl�CE) T1115IS�OUFl PLRM1IIT <br /> � a4�UC�TIONACLfPTF.�OV- PlAf:5b1i�.CK(004. /.PPfiWEDLbPI55U.NCClIV <br /> �.. .� <br /> � 3 I <br /> �,.�._ . . .__. . <br />