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r.PPLICATION FOL.- ���,�„ <br /> '°.`".,°,"° CONSTRUCTION O <br /> �,rv o, <br /> Fverett PERMIT <br /> 6�JILDING DEPARTMENT <br /> 259-eB10 TO BE COMPLETED IN INK• PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION �YBUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN � <br /> owr�in u+n �nmuss r�n �ic rr�o�u <br /> ��q�s_ �'i i)�22o�1���,Y<ri� �;.9✓.✓_c�J•it,��� ,3�OlnS«�/L�Jrlc �'� `J��Z�Y J'39-�7�.3t/ <br /> •nCrmeUanUFSiariin M�ii�ooulss arv n� rrw�a. <br /> p�q p4CON@ .I011 M�:I �b0445 f.i1Y !IP f1�ON[ UCEN9f� <br /> �s 1 <br /> Ji�:r� .�-�v�c.�.:,, h�r_ 3bU� Ji,�;-1� �l�e 4�( �'�'2t/ 3.sS;�3✓ .5�rtsi�/�i✓�r <br /> u�UUq�^�� CONnuPnq a.n eumrtss cn. zu� � rr�or�E uctHsr. <br /> �'LUMP�WiCU111H�G10P M�II �OONC55 OIY IIP fn10NE lICl115L• <br /> l 55 O�viUnr — — <br /> , yEW ❑ ADDIfION ❑ ALTEf1AilON ❑ REPAIq ❑ DEMOLIIION ❑ WOODSTOVE/FRPLINSERT ❑ BWLOING RELOCAIION <br /> w�u�nnr.��rvium�ros�n��yunnv.��i.. �.� �7-7 / � � <br /> _(:1�r7lu.0 `'Nl :_ I l T—. _ — . �.l L <br /> o�scnna wnTK 1�/�� � / r / <br /> I�0-[-im..�f.�- ✓ •.J.l�� �ilAiiL ,,. f � - . I aiLu e� {lR inut..( 1�....'.1i+ ����6v. <br /> 7 <br /> usr o��:�u���o,�J I HEREBV GERTIFY THAT I HAVE READ AND EXAMINED THIS AF� <br /> " )•I� (l� i PLICATIONANDKNOWTHESAMETOBEiRUEANDCORRECT.ALL <br /> imuotsr.ninnonu� oaorcr,nrn�nwr�iciawon�n�cHrouncrn�irs� pqOVIS10NSOFLAWSANDORDINANCES�OVEiiNINOTHISTVPE <br /> q � J� - �,� � • OFWORKWILLBECOMPLETE�WITHWHETHERSPECIFlEDHERE <br /> �n��moc�r.�t—or � INORNOT.THEGRANTINOOFAPERRIITDOESNOTPRESUMETO <br /> GIVE AUTNORITY TO VIOLA?E OR CANCEL THE PROVISIOP75 OF <br /> ' � ' �: .)� ;� . � '��,� ANVOTHEfiSTATEORLOCALLAWREGUTATINGf,ONSTRUCTION <br /> OR THE PEFFORMANC�9 OF CONSTRUCTION. <br /> SIpN�IURE Of CONTRALIOfI PR AUOIOq11CD�OlNI O�IE <br /> \ <br /> / .p ro <br /> a� ,�;i � �_1v2���{,� ���,�..� i �'ti x / _ — �e .' � � � 9�'7 <br /> ����or euuri[ss ���tICAN�5CI1Y11USINESVlIGL11tiEN0 <br /> 4 18 l �.. E. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%tURE OA ITEM FEE NO. TYPE OF EOUIPMENi FEC <br /> WATEPGLOSEi�701LET� s A�C—A/HNDLOUNIT9—HP <br /> BATHiUB �EFOIGER�TIONUNITS—HP EA. <br /> IAVATOf1Y�W�5HB�51N� _G BOILEP$—O.TU/HP <br /> SNOWER OAS FIRED A C.UNiTS—B T 11 <br /> ItITp1EN SINN 8 DISP FORCEU Alil SYSTEMS—B T U. M EA. <br /> DISMW�511ER �� W�LLHEATEfiS—O.TU M <br /> IAUN[1qY TR�Y UNIT HEATERS—OS U M <br /> CLOiHES WASNER EV�POPATIVE COOlERS <br /> URIIlAL CLOTHE9 ORVERS <br /> O�INI(ING FOUNiAIN VENTILATION FAN <br /> FLOOR DR��N 11ANGE 11000 <br /> gRCNFIOW PREVENIEf15 WATE�HEATER <br /> �OOF DRRINS—RAINlF.A0ER5 �'�'OOD SiOVE <br /> SINN�SERVICE—B�R.ETC I METAL FIAEPUCE 6 CNIMNEY <br /> fIf1EPLACE MSERT <br /> IIEAi PUMP <br /> GAS PIPINO <br /> EkHAUSTFqN <br /> 9UBiOTAL S SUBTOT�L <br /> PE�MIT { P[RMIT <br /> TOTALiEE ! TOTAIFE! I <br /> �iinnt�sl inu.• nl+n�d�n�Cn SmE 9CRUCn �'�AN LMEC NUMOEf1 FEE ` + ��� �. RECEIPT'NO <br /> -�, � > 7..s _ . : � I'-' l._�i f '">,�; - `— j< Y��l'� . <br /> °Gf 1����� �°�""�� vnr.ern snc FEES VALUATION FEE <br /> �1�-S �"{' � '�i ures nr�o <br /> — BUILDING S <br /> ��itr rrnr.� ncrurnm;�r.nour r�ooinwiuwauens _ <br /> � � � �� � I PLUMBING <br /> S�ff OI p�Ptl 11�1 ')I SIUIIICS N�[ OLf, lU1D � <br /> //j� , �� MECHANICAL <br /> ��— OfNER <br /> fIRE SPRINNLEi7S REOUIPED I] YES U fJ0 <br /> ST�TE BU0.01N6 SURCMARGE <br /> STATEENEPGvSURCHaRGE <br /> u�r�n ei�.py.�r q. rieq5i[qECKEDOr erpnl0n�5511�NLEBr <br /> PUBLIC N'ORNS <br /> \' ,(•` ��� ��G TOTAL <br /> Pf70PERTV OWNERS ARE RESPONSIBIE FOR DEtERMININO ALL <br /> PROPERTVLINELOCATIONSANDRELATEDEASEMENTS. <br />