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�'��PL��A�ION FOn �evcr-en� <br /> '"'f".ro`"" CONSTRUCTION U <br /> c�rr oc <br /> ev�rett PERMIT " <br /> BUILDING DEPARTtdENT �,� gE COMPLETED IN INK- PLEASE PRINT <br /> 259-BB10 <br /> ❑ DEMOLITION ❑COMBINATION ❑ BUILDING ❑ MECHANICA� ❑ PLUM8ING �i(SIGN <br /> �µ�Cn MnIL AppRL55 CItY IIF PIIJNC <br /> �� � ,'"��v:eii.v �ic �o%Gt� �S�v 5.?su- - �is ��'Y�n.d.� l:i��'S �S�v-S y6� <br /> LpO1rtLClORUFSiLHfR MAIL�OOPE55 C ZC ObL <br /> 70 y <br /> �tNCP1l GONiR�C�OR `ANL�OORC55 C�tt IIP �L��'S3 L6CNSE• <br /> �H �' �-i�1�.�J� � /Jr- ��s's cJ // �' ��/��:uE' S'l�R •>s -i�rvv �';��s�.�x <br /> N��i MtCH�N�UtC�qrluctOq v4l�onFtsS c�iv l o E LC[ s[ <br /> H H <br /> �H '.il no�.�ni,;;r.o�+rn•eron Mui�ooness arv z�v w�o�e uaNse. <br /> oxo <br /> '�tl H '{I <br /> N M <br /> a.ass o�woaK <br /> �� � rypW ❑ AODITION ❑ ALTERATION ❑ FEPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUIIDING RELOCATION <br /> �.�. "u' '.R104i'ONOfW00.^ �OliA4iE��>LSFWSLPADPi . <br /> Q�g � �i�C;t`�� - <br /> r.t�.cn�eewanK <br /> �"� cPG ' �rsT�-' 1.� U ,/ ` / ' � :'� , 'c` �U ' � /14LL �/C.l� <br /> zy� u�i.or�7e4uo��+c � <br /> � /� f I IL �� � I HEFEBV CERTIFV THAT I NAVE READ AND EXAMINED THIS AP� <br /> x <br /> PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> tyyy irc<�.oes[nirior�o�FnoPea*r�sHowN�aowo'�nitnc�vouncowcsi PqOVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPE � <br /> Ay OF1h'ORKWILLBECOMPLETEDWITHWHETHEHSPECIFIEDHERE� <br /> �� io+—oioc�—o� INORNOLTHEGRANTINGOFAPERMITDOESNOTPRESUMETO <br /> � GIVE AUTNORITY TO VIOLATE OR CANCEL THE PROVISIONS Of <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> y OR THE PERFORMANCE OF CONSTRUCTION. <br /> � � SIGNAIU��E Of C0�1TR4CtOH On:.UirnT9il[p aGENI I141E <br /> � �� .� ,,�J)'1 X�-��`� <br /> • < V'FOJECi�p�R[55 V AVPL�GNiSCIlY0U5�NL5SUCLIRC�U <br /> ��1�'��� � � L�IC-'/J�t(_ Y�,� � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR I7EM FEE NO. TYPE OF EOUIPIAENi FEE � <br /> WATER ClOSET ITOILET� ArC—AiMN�LG UNITS—H P - <br /> '�, BATMTUB REFRIGER/TIONUNITS—IiP EA. <br /> LAVATOBV(WASM BASIN� BOLLERS—�t U n1 P <br /> 1 ' $NOWER GPS FIPEO A C UNITS—B T.U. <br /> � FORCEOA�ASYSTEMS—BT.U. MEA. <br /> KITCHEN SINN b OISP <br /> '�1 OISHWASHER WALLNEATERS—Oi.U. M <br /> LAUNORYTR/Y UNITMEAiERS—O.TU M <br /> 1 ' CLOTHES WASMCR EVAPOFATNE COOLEPS . <br /> � <br /> URINAL CLOTM[SORYER$ <br /> `�1 pqINNING FOl1NTAIN VENTILATION F�N <br /> ; FLOORORA'J RANGEMOOD <br /> ' OPCKFLOW f�EVENTERS WAIERH@ATER <br /> f � <br /> ROOF DPAWS—RAINLEAOERS \VOOD SiOVE <br /> ' SINK�SERVIC°—�AR.ETC� METAL FlREPLACE 8 CMIMNEY _ <br /> FIREPIAGE WSERT <br /> � ' MEPT PUMP <br /> GAS PIPING <br /> � ' E%HAUSTFAN <br /> � ' SUBTOT�L S SU9TOTAL <br /> PERMIT f PERMIT <br /> ( '�1 -- -- TOT�LFEE f TOTALfEE <br /> 1 ' P�AN GMECH NUMOER FEE RECEIPT NO. <br /> II�tiHiSliOAC� BEAR$[iBACN $I�ESEiOACM <br /> - ,�;.�;.mi iornnu �qcpHryii� � FEES VALUATION FEE <br /> /J�� �res r.ruo S <br /> D OUIL�ING <br /> 1�:`I O�CONSi OCCUFI.NCY GFOOP NO OG DWELLI4G UNItS �. <br /> PlUM01`A.:•. <br /> sG[oroiDO r+o or5i0aiE5 ra�x oCc ioRo MECMANICAL <br /> OTHER <br /> FIRE SPRINKLERS F7EOUIRED ❑YES ❑ NO STATE DUILDING SURCMAPGE <br /> STATEENERGYSUFCNARGE <br /> mr,�c<noa.�:: u. �i>�+Sp�� rcEOBv ePVRiORi55U�HGEBv pUOLICWORKS <br /> TOTAL <br /> PROPER7Y OWNERS ARE RESPONSIDLE FOR DETERMINING ALL � <br /> PROPERN LINE LOCATIONS AN�(7ELATEO EASEMENTS. <br />