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iM f nrprNn <br />C�rv or <br />everett <br />BUILDING DEPAF71�1ENT <br />259�88 7 0 <br />`�.PPLICATION FO..' <br />CONSTRUCTION <br />PERMIT <br />TO BE COMPLETED IN INK • PLEASE PRINT <br />❑ DEMOLITION O COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />uwnn u.neuoutss r.nr zm ounvc <br />'A('r0/J1� ���I��„J �rSiJ �:A'!;r'Sn1u� ,7u �clf�ii� :�JVZI ia5-YJ"`l <br />•nuuq[IOnU!•.��iriln MuI�U[1i�155 Citr }ir �vun�1. <br />�lblf4lCONIf1�f1U� M�i1Mtl111[55 C�Iv P�� �'��ONI UCtNS(• <br />M�II �OpPI SV <br />GIY ll^ PIIONE UCfHSf • <br />Q ��'� 1 (L <br />�•iw�mn•:eoa�nu,iui� M�nnonness air ru� Vruorre uier�se. <br />C1�56111 WON� <br />❑ II[W ❑ A�DIIION ❑ AITERATION ❑ REPAIH ❑ DLMOLIIION � WOOOSTOVE/PRPI INSERT ❑ BUILDING HELOCAl10H <br />vu vu��n� rn wnn..cn5� ui r�n n nu� �'. n� us Llrnn� <br />L� •.Onlu wqN• --- <br />J.i. n�l il�..�.1 1" '.'��� IP. <br />U\I [11�1111tO�N0 <br />/l` � <br />.Si,.ib� l (A..i.� � fs <br />lrnMne;cmmiw�orvnorc rv�snuwHaEl� <br />ia�—_oiocn_a <br />PnOitCl�UUuf55 <br />� 5.�io ;Jorr.�,r.�i i1P <br />PIUMBING <br />NO. 1YPE OF FI%iUI�C OR <br />WATEn CtOSET (TOILE f� <br />o�n�r�o <br />U�A I OfiY 1 W �5�� BAS W � <br />SHOWE�7 <br />NITCHEN $INK 6 OISP <br />OISMWIISHER <br />LAUNpRYTOAY <br />CLOTHES w�5MEf1 <br />VRIN�L <br />OA�NNINO fOUNTAIN <br />flOqll Of1AIN <br />�Af:MfLOW Pf1EVEN1EfiS <br />pOOF 01141N5 — I1M1lLEAOEf15 <br />SINN �SE�VICE — dAR F.TC � <br />si m:c. - <br />FEIIMIT <br />fOT�I fEE <br />nv.n �.� �nnc+ <br />i iiune <br />ucru��.ucrcrour <br />�m ,n .innrts <br />fIRE S�'R�NkLERS REOUIREL' Ll YE3 <br />lOURf.OMfR� <br />��. <br />veberU m�1. <br />❑rES I1N0 <br />i�o or owri.ur+n uru�s <br />M�Y OCC lP�p <br />n��r�i.:�u✓�µ�N.— iiuKinttKltrOr u�rn�on <br />�_� <br />—_..— __ �_- <br />1 HER[BV GF.qTIFY THAT I HAVE READ AND E%AMINED TfUS AR <br />PL ICATION AHD KNOW THE SAME TO BF TFUE AND CORRECT. ALL <br />PROVIS�ONS OF LAWSAND ORDINANC�S GOVERNIN6 THIS 1VPE <br />OF WORK WILL BE COMPI.ETED WITH WIIETIIER SPECII"IED HERE- <br />IN OR NOT. THE GRANTINO OF A PERMIT DOES NOT PqESUME TO <br />GIVE AUIVIORITY TO VIOLAIE OR CANCEL THE PROVISIONS OF <br />ANV OTIIER STATE OH LOCAL LAW REGULATIN�CONSTRUCTION <br />O(i TFIE PERFORMANCE OF CONSTRUCTION. . <br />SION�IUBEOfCONIR�r�OROR�Uf��Ol14EO�UENt wre <br />\ l <br />i <br />�X �_i �� � <br />= - .�3/K� <br />�nv�iGNrecnrBusiH .s ty[ris[No <br />/ <br />MECHANICAL <br />M/V— IVULUVIYIIS—�lY <br />REFRIGEi1FTION UNIT S— H P EA <br />OOIlEpS — 8.T U M P <br />OAS FIIIE ": UNITS — B T U <br />FOf10ED Rln SYSTEMS — B T U. <br />W�LL NEATERS — 9 T U <br />UNIT 11EATER9 — B T U <br />EVAPORATIVE COOLERS <br />CLOiNESORYERS <br />VENTILAiION F11N <br />ReNOENOOD <br />W UEfI MEA1En <br />wO005TOVE <br />METAL FIREPUCE 8 GNIMNEY <br />FIREPLNCEINSERT <br />HEAT PUMP <br />OAS PIP1/:0 <br />EMIIRUiT FAN <br />6U8 TOTAI <br />P[RMIT <br />TOT�LFEE <br />{'LAN �HECK NUMOE(i I FEE <br />BUIl01NG S <br />M.UMBING <br />MECN�NICAL <br />OTHEfI <br />STATE BUILDING SUi1CHAf1G <br />StAiEENEAGYSURCHARGE <br />PUBLIC WOPKS <br />TOTAL <br />M EA <br />M <br />M <br />NECEIPT NO <br />FEE <br />{`fiOf ERiY OWNERS AfiE i7ES1'ONSIBIE fOR DETERMININO ALL <br />PROFERTYLINE IOCATIONS AND RELATED F.ASEMENTS <br />