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� <br />( n� E��.���:���� <br />! �� �� �� <br />everet� <br />LrtV NALL 'SYP�.b <br />EVCNFII. :p:.SNtILILN <br />9tP:11 <br />°E°� °° �°"�'°''"� BUILDING <br />otvEior�aun <br />OWNER.. .. . . .... � <br />R <br />[1'6UILOING �PLUtABING �MECHANICAL <br />VAWATION OF WOIiK <br />5 3i7Q��.. <br />DESCRIBE WOiiK <br />, .... ; <br />��voPoseo usE <br />LEGAL DESCRIPTION OF PROPERTV ISNOW 6E1 <br />FOU�R �C�O��P(IESI <br />LOT�a.�G' '+1_ 9LOCK�OF ����'�"�'�� �1 <br />, 'SO� O;' j' ?'C? ^'C <br />J06 ADDRE55 <br />4: n3 I.!'fC.� ;'•C• <br />PLUMBING <br />Il\ <br />SINK <br />FEE <br />SPECIAL CON�ITIONS: <br />IL <br />CfJh4 �T�t►�€'T�it:��t <br />PERMi'T <br />MECHANICA.L <br />nnnHFSS ZIF <br />PHONE <br />PLUMBIN� <br />NO. <br />OF WORK <br />�]NEW ❑"DORION ❑ALTEFATION ❑REPAIH <br />❑DEMOLISH ❑f[NCE ❑SIGP! ❑SWIMMING POOL <br />MECHANICAL <br />AIF COND. UNITS-H.P. EA. <br />REFPIGEfinTION UNITS�-H.P. EA. <br />601LEF5 - H.R EA. <br />Gf�S F�FED A.C. UNITS-TONNAGE El <br />FOPCEU AIR SYST'cM5-6.T.U. M EA. <br />WALL HEATERS-6.T.U. M <br />UNIT NEATERS-�.T.U. M <br />EVAPORATIVECOOLEFS <br />CLOTHES DRVEPS <br />AIR HANDL <br />INCINERAT <br />C.F.M. <br />.� <br />everett <br />i t .... <br />5 <br />� <br />W <br />m <br />� <br />� <br />z <br />r <br />� <br />� <br />W <br />a <br />zsss <br />� SUBTOTAL 5 � <br />—� PERMIT 5 ( <br />I TOTAL FEE 5 I <br />�-- THIS PEFM11IT f3ECOMES NULL AND VOID IF WORK OR CONSTRUG <br />TION AUTHORIZED IS NOT COWMENCED WITHIN 120 DAVS, OR IF <br />CUNSTfiUCT10N OR VIOPK IS SUSPENDED OR A�l�NOONED FOP ^, <br />PERIOD OF 120 DAYS AT ANV TIME AFTEF WORK IS COMMENCEU. <br />I 4ER[DY CERTIFV "i HAT I HAVE REA� AND E%AMWE� THI£ AP� <br />— P�ICATION AND KNOW THE SAME TO �E TRUE AND CORRLCT. ALL <br />PROVISIUNS OF LAWS AND OFDINANCES GOVEPNING THIS TVFE <br />OF WOFiK WI�L OE COMPLIED WIT11 WHLTI/ER SPcCIF1ED H[REIN <br />OR NOT, THE GRANTING OF A PERMIT DOES NOT PR@SUME TO <br />�' GIVE AUTNORITY TO VIOIATE OR CANCEL THE PFOVISIONS OF <br />ANY OTH@R STATE OR LOCAL Ll6N REGULATING CONSTf±UCTIQN <br />_ OfiTHLPERFORMANCEOFCONSTRUCTION. <br />5 __—� <br />5 i <br />X a <br />SIGNATUPEOFCONTRI�CTOflORl1UTH.AGENT UATE <br />REAR VARDSETe3ACK �'LnN CHECK NUM1I6LR PLAN CHECK FEE � <br />F[E FECEIPT NO. <br />VACANT SITE <br />_ .�"_ _ <br />❑YES ❑No FEES � VALUATION FEF <br />NO.OF DWELLING ---� <br />UNITS I � <br />DC0. LOAD 11UILDING S <br />PLUMBING <br />IPflINKLERS <br />I(:ED <br />ES ❑NO MECHA�lICAL <br />OTHER <br />PENELTY SEC. 707 (al <br />TOTAL �� [� <br />PERMIT VALIDATION <br />— WHEN PROPEflLV Vl�LIOATED 11^! TH:; ��AC[) T1115 IS YOUR PERAIIT <br />p.v �I'IM1'JOIICI.'(pLY APCPOVfl110111$SUAI <br />I 4:• rY <br />