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tl;e Evergmen <br />GTV OP <br />ev�prett <br />nrru.�u P59B805 <br />EVEPElt,1'IASIItNGiON <br />9BI01 <br />°E"°'°°M"°�"r BUILDING <br />OEVEIOPNF111 <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL PLUMBING <br />everett <br />OWNFR MAILADURE55 ZIF PHO}N/E <br />•�. . i.��`..a.�..��� 4i�+1'3il' t'+J'!i"lI <br />AftCHITECT OR OESIGFER MAIL ADORESS PMONE LICFNSE NO. <br />GENEFALCCNTRACTOR MAILADDFE55 PHO!N�,E LICENSE NO. <br />. �4��'I <br />MECHANiCAL CONTRACTOR MAIL A��RESS PHONE I.ICENSE NO. <br />PLUM6ING CONTRACTOfl MAIL ADDRESS PHONE iJCENSt h0. � <br />W <br />m <br />PERAIIT CLASS OF WOflK � <br />z <br />� DUILDING � PLU1A81NG � MECIiANICAL {- <br />— �EW ❑ADDITION ❑ALTERATION ❑REPAIF � <br />VAI.UATION OF WOhRK [L <br />5 ��y: ❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL a <br />�ESCFIBE WOHK <br />.. ; .K.�, s�,a.� 2765 <br />PROPOSED USE MECHANICAL <br />LEGPLDESCRIPTIONOFPROPERTYISHOW6ELOWORATTl.CH TYPEOFFVEL �OIL QCnT. �LPG. GELEC. <br />FOUfI COPIESI — <br />IVO. TVPE OF E�UIPMENT FEE <br />LOT pLOCK_OF AIR CONO. UNITS-H.P. EA. 5 I <br />`-R� ,� v� _ flEFRIGEfiATION UMTS-H.P. EA. <br />'•C ��V f301LER5-H.P. EA. � <br />GAS FIREO A.C. UNITS-TONNAGE EA. <br />f-OFCED AIR SYSTEM5-0.T.U. M EA. � <br />JO� AOI)RE55 �� � WALL HE/1TER5-B.T.V. M <br />r <br />"'�� VNIT HEATERS-B.T.U. M 1 <br />EVAPORATIVECOOLERS <br />PLUMBING CLOI'HES DfiYERS � <br />VENTILATIOIa FAN <br />fiANGE IIOOD � <br />AIR NANDLING �1NIT- QF.M. <br />NO. TY'E OF FIXTURE Oq ITEM FEE I <br />WATER CLOSET (TOILET) 5 �NCINERATOR I <br />BATHTUD <br />LAVATORVIWASHBPS�NI I <br />SHOWER <br />KITCHEN SINK & DISP. —� SUB TOTAL 5 � <br />DISH'NASIIER PERMIT 5 <br />LAUNOP.V TRAV TOTAIFEE 5 <br />I <br />CI.OTH[5 WASHER THIS NERMIT BECOMES NULL AIJD VOI� IF WORK OR CONSTRUG <br />WATER HEATEfl TION l�UTHOFIZED IS NOT COh1MENCED WITHIN 120 Cl�vS, Of� IF <br />URINAL CONSTRUCTION OR WORK IS SUS�'CNi:f n'+q A�ANDONED FOR A <br />DRINKING FOUNTAIN PERIOO OF 120 OAVS AT PNY T:l'E PeTERbVOFK ISCOMMENCED. <br />FLOOR-�SINK OR ORAIN I HEREBV f.I:flTIFY THA� I HAVE REAU AND E%AMINED THIS AP� <br />VAGUUM OREAKERS PLICATION AND KNON THE SAMF_ TO PG TftVE AND CORRECT. ALL <br />PROVISIONS OF LqWS AND OROINANCES GOVERNING THIS TYPE <br />fi00F DFlUP15-P.AINLFADERS OF WORK WILL BE COMPLIED WITH'.YHETh1Efi SPECIFIEiJ HEFEIN <br />SINK (SEHVICE�-�AF, ETC.1 OR NOT, THE GHANTING Of- A PERMIT DOES NOT PHESUhtf.� TO <br />T GIVE f�UTHO(iITV TO VIOLATE OR CANCEL TH[ PROVISIODS OF <br />qNY OTNER STATE OR LOCAL LAW REGUL/�TING CONSTRl�CT10N <br />OR TIiE PERFORMANCE OF CONSTflUCTION. <br />SUBI'OTAL <br />PERMII' S —T— <br />TOTAL FEE 5 � x �� <br />SIGNATUHEOFCONTRACTORORAUTH.AGENT DATE <br />SIDE YARD SETBACK STREET SET�i�CK REAp'VARDSET�ACK PLAN CHECK NUMBEfi PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE 20NE LOT AREA VACANT SITE <br />❑vEs ❑No FEES VALUATION FEE <br />TVPL GF CONST. OCCUPANGY GROUP VNIT�S �WELLING ' <br />SIZE OF �LDG. NO.OF STORIES MAX.00Q LOAD BUII.OING 5 �'��^MV✓ �` �w <br />_ —.1 <br />PLUM�ING � <br />FIREZONE ,DASEMENT RRESPRINKLEFS � <br />FE�UIR9� I <br />❑YE'� ❑NO MECHA�JICAL � <br />9PECIAL CGNDITIONS: OTHEfl � <br />�i u' tTS— C.:S' Cv^ilG� c ' � <br />. � I1.!$: , '�,�� =: ��'— <br />PENELTY SEC.1031n1 1 <br />— � TOTAL 7�4 �`� <br />�..� ..,.-. .. .,_, — — <br />.,, z ,. . . - „_r' i n=L -� ."c.�'- A��'� PERMIT VRILIDATION <br />— WHEN PHOPER�Y VALIUATED IIN THISSPACEI THIS IS VOUR PEftA11T <br />APPLIGi1011nCUi9C�tiY 1'LANSCIIELKEDDY_ APPPOYC9�OII1.`.CUAIiO�fll <br />♦ • <br />:t <br />