|
�._� �
<br /> 1
<br /> ,,,, ; , �, ,,,.,.,� ',
<br /> ���, �>�
<br /> (:OfVSTR�7�TIC1� everett i
<br /> � PERMIT
<br /> �
<br /> II Pv�r� �I
<br /> �Y� Ilittl t5'J88P.5 ,
<br /> �� IV.fiEfi.�9Tfi�IrtlGtllq �
<br /> 9���� BUILDING MECHANICAL PLUMBING '
<br /> � nu�i ni rnusneiur �
<br /> � OfvELOPP[bi PIIONE �
<br /> MnILlODNE55 ZIP . . . .
<br /> I OWNER . . . .�.- . . . . . " ' ' ..:f . " � � . . .._�
<br /> , � _ �. . ^i I
<br /> � ' '_C��:::�' '� � ' � -- PHONE LICFNSF. NO. I
<br /> AqCHITECT OR �[SIGNLR MAIL ADDRESS I
<br /> I PHONE LICENSE NO.
<br /> GENERAL CONTRACTOR MAIL ADORE55
<br /> �
<br /> I .r•'•"•r: PHONE LIGEN56 NO. I
<br /> M1'ICCIIANICALCONTRACTOR MAILnD>RESS
<br /> ,.. �� '�a; Y L Y i. (r I
<br /> I �,_, ,. � ., . ' ,��:r.i:: : _
<br /> ��-�-� '`�''�"�" PHONE LICEIJSi �VO. W i
<br /> PLUMBING CONTRACTOR MAIL AO�ftESS m I
<br /> I - . .-•. ��r.' „_. . '^ t" rOL:.'�:��l .'::�.)_'':'��1 �. � I
<br /> i 5�l�jSL�:2 .Jl'.f� . �
<br /> L,...I_ �� • CLASS OF WORIC z
<br /> �y F' I
<br /> �BUILDING QPWM8ING uMECHl1NIGnL ONEW ❑nDDITION ❑ALTERA�ION ❑RBPAIF L
<br /> VALUATION OF WORK w_ II
<br /> ❑DEMOLISH L;rENCE ❑SIGN ❑SV+IMNING POOL a
<br /> � .� r;.n�l;�. �� __— �
<br /> 5 , � : . —---- 2235
<br /> DESCRIE3f WOFSK
<br /> .::..;r'_.. �:?J:':1��' �...:rS•..c::-:C:;
<br /> VROPOSED USE MECHANICAL �
<br /> -,. 7 ,. n:� .. • � _"__"- --_
<br /> _i.n.:i1..? . .R'.:�.. ...3.s1'.CCC•:: ____—" I
<br /> __ TYP[ UFfUEI '�0��� �G�T. '�LPG. � � �
<br /> i rr.ni. oescaiano�d OF PROPeRTv �SHow 9E�ow aa nrinGi � ----TVPE OF EQUIPMEN'i FEE _ �I
<br /> i Fo�acoeiesi :�?i: ''.�i��•r = _> — "°'�
<br /> i 5 i — I
<br /> LOT " 6LOCK—OF , �.IR COND. UNITS-H.P. EA.
<br /> I 'r cL'��` � t� � __}RGFRIGERATION UNITS-I�I.P. EA. - �
<br /> d BOILERS-��.P. EA. �
<br /> � _�GAS FIRED N.C. UNITS-TONNAGE EA. _` II
<br /> �I -- -_ _ _� fORCEO AIR SYSTEMS-6.T.U. M EA. � -
<br /> '1Vl�LL HEATERS-B.T.U. �+7 I__ i .
<br /> I
<br /> J08 ADDFEi� .� - Id �-- � - 'I
<br /> -. V � .:,V..�� ._ . . _�<IT HEATERS-B.T.U. i
<br /> -- �- � E':APO RATI V F COO LE RS i
<br /> CLOTHESDh'YEFS �1� ���� �
<br /> PLUMBING — - �
<br /> --� VENTILATIOIJfAN ;� ;
<br /> `I
<br /> ! HANGEHOOD '�I
<br /> AIR HANDLING UNIT- C.F.PA.
<br /> p, TVPE OP FIXTURE OR ITEM c �fi�Cc � INCINERATOR � ��
<br /> � NlATER CLOSET(TOILET) _ ._ --wl- � � I
<br /> I J. BATHTUB "--— }-- . � - I �
<br /> LAVl�TORV IWASH BASIN) . ___�� II
<br /> I _. `7 I -_ __- i
<br /> � SHO�^1Eft SUB TOTAL 5 ^,11,y_
<br /> ^ i
<br /> ' ' KITCHENSINK& DISP. , .. pEFM1T 5 �� '•'�
<br /> � � DISHWASHER TOTALFEE 5 �I I
<br /> I LAUN�FVTFAY � ; '
<br /> �� CLOTHES W�+SHER '� � THIS PFRMIT 6ECOMES NU�L ANC) VOID IF WORK OR CONSn�U F� i
<br /> WATEF HEATER TION AUTHCRIZED �S NOT COAiR'ENCED WITHIN 12G D/IYS,
<br /> � CONSTflUCT10N OR WORK IS SUS'ENDEG OR A�ANDONED FOR A i
<br /> URINAL --'�- PEFIOD OF 120 DAVS NT AN�' TIME AFTGP WOFK ISCOMMENGED.
<br /> I _ DRINKING f-OIJNTAIN._. � HERE6Y CEftTIPV l HAT I HAVE READ AND EY.AMMED THIS AP� �
<br /> FLOOR-SINK OR DFAIN —�-- p�ICATION ANU KIJUW THE 5l�A1ET08G '�RUE AND CORftECT. ALL
<br /> � VACUUAA eREAKERS PFOVISIONS OF LAWS AN� ORDIt�AN(.LS GOVLRNING THIS TYPE
<br /> � ROUF �flAINS-RAINLEf.OERS OF YVORK WILI 6E COMVLIED WITH WHETHEfi gPtCIFiEU HEftEIN
<br /> I SINK (SERVICE-6AR, ETC.1 � Of� NOT, THE GRANTING OF A PEFMIT UOES NOT PRESUME TO
<br /> GIV[ AVTHORRY TO VIOLATE UH CANCEL THE PflOVI510N5 OF �
<br /> � �--.- ANY OTHER STATE OR LOCl�L LAW REGULATING CONSTRUCTION II
<br /> OR TNE PEFiFORfdANCE OF CONSTFUCTION. �
<br /> I 5UDTOTAL - _ . I
<br /> PERMIT S
<br /> '� ; f't� �
<br /> I - TOTl�I FEE 5 /��_ I
<br /> 51GNATVREOFCONTRACTO�OFAUTH.AGENT DATE I
<br /> PL/1N CHECK FEE
<br /> SIDE VI�FDSETBACK STREET SETBACK FEl+R VAF�SET�ACK PLl�N CHECK NUMf3Efl RECEIPT NO. '',
<br /> u, -. '� .. FEE � - . ... . ;'.���..�, ,
<br /> 'j'7._ �:i.j i .. .
<br /> I LOTAREA �. ., VACANT�SITE - ��
<br /> , U5e Zonl�_� o �•: �� �,ES ❑No FEES VALUATION FEE
<br /> I I
<br /> �� TYPE OF CONST. OCCUPANCV GROUP NO.OF D�ELLING
<br /> UNITS
<br /> 7 _ � 1. , . I.. '1
<br /> I •.�'_�.. MAX. 00G LOAO BUILDING , . . . . � ' I
<br /> � 512E OF BLUG. NO.OF STORIES �� I
<br /> � ....,T 1.... I , I
<br /> 'I yit .5�;t1 •.. .. � PLUM�ING . I.
<br /> BASEMENT FIRESPRINKLEFS -'a I" � I
<br /> fiRE ZONE ryE(]U1RED �� I
<br /> -•'�� ❑VES ❑NO M1IECHAI'JICAL �,
<br /> - I
<br /> OTHER � �
<br /> SPECIAL CON�ITIONS: — I
<br /> I PENELT� SEC. 3031a1 � �
<br /> . -_ .. : I"� ' i
<br /> TOTAL I
<br /> — I
<br /> ' - - PCRMITVALIDATION i
<br /> � - JJ!IcN FFiOPEFLY VALIDATED IIN TFiI55PAGE1 THIS IS�OUR PERMR
<br /> I
<br /> I
<br /> ' _'_ I
<br /> I
<br /> , .:,.1::.�-,`,.�,__�����_�, �ie��co6cKfnM� PFPfiOVCDFOhISSV�t1CLilv 'I .
<br /> i . � � � ,'
<br /> , �
<br /> ,
<br /> -
<br /> ,------------------- -- ,
<br /> �
<br /> �
<br /> ;
<br />
|