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, _�'PLICATION FO1.� � ���,�„ <br /> '"'`"'°`"" CONSTRUCTION O <br /> C �OF <br /> �verett PERMIT <br /> BUILDING DEPARTMENT <br /> pgg_g�48 TO BE COMPLETED IN INK- PLEASE PRINT � <br /> ❑ DEMOl1YlON ❑ COMBINATION ❑ BUILDING O MECHANICAL ❑ PLUMBING �SIGN�r <br /> OWH�q M/.IIR��RC55 CRY lIF VNONE '4`� <br /> J1 <br /> �p�I1E�ORD�IONEB �MRIl�f5.5���,�����' !IP PNONC L� <br /> .��� <br /> GENFML CONIf1�ClOR MM�POURE55 CIiV Z�P �I�ONE IICCNS[• <br /> �L��_ �]� � n�o��n sT s-r=n�rr-�= n���n �-c���� •7u ec��c�$��� <br /> Mrc�uHic.�coe�nec*oa Meu�oon[55 cnr nr rHo�iE uccHsr• <br /> FWMflIN6CONIMGID� Me1lADDBE55 CITY ZIi' PHOYE UCENSC• <br /> C1�55 or WOnn <br /> � NEW ❑ ADOITION ❑ ALTERATION ❑ HEAAIii ❑ DEMOU710N ❑ WOODSTOVE/FHPL.INSERT ❑ �UILDING REIOCAiION <br /> vew�i�On or woA��COS�or rn�tfn��LS nLU9�A9on�Cl/1/�� '(� <br /> l.•C. <br /> o[SCniDf woRK <br /> i.,<-„�, n .-, u �,u�,rnn t ll) ni� r �o�� �'ic� 1�����a� a rt..A� �xi�ri Y�� -{�?.1�-n�7M'�yC- <br /> usco�amio�r�, /� `1 I HEREBV CERTiFY THAT 1 HAVC- READ AND EXAMINEUiHIS/(P.", <br /> ��1'�� `,�'7"��`-�I� ) PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL <br /> LEG�lDf.SCRIPl10NO��RO�CRTY�9NOWNBELOWOH�IUCMfOURGOPIE91 PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> QF WORK WILL BE COMPLETED WlTli WHETHER SPECIFIED HERE- <br /> �o�—e�oc�—o� IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY 70 VIpLATE OP CANCEL THE PROVISIGNS OF <br /> ANV OTfi[R STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE Of CONSTRUCTION. 'y <br /> SIGIJRL EOfCO��RCiOfiO��Ui110f117CDFGf.Ni D4TF. ( •zd•� <br /> � 1 <br /> , <br /> PiIOJ[Cf�D�RESS ���ULPNTSGItv 15i SSI�CENSF. �JOI-�� <br /> OU <br /> J 72� �� <br /> PLUMBINO _ M ICAI _ _ <br /> NO. TYPE OF FINTURE FEE NO. iYPE OF EOUIPMFNT ___ FEE _ <br /> WATER CLOSET(701LET) A�A COND. UNI75–HP.EA. _ <br /> BATNTUB _ REFRIG[RATION UNITS–N.R EA. __ <br /> 1�VAiORY�WASH BASIN� OOILERS–H.P.EA. __ <br /> SHOWEP GAS FIBED AC.UNIIS_TONNAGE EA. _ __ <br /> NITCHEN SINN 6 DISP. POPCED AIH SYSTEMS_81D. M EA __ <br /> DISNWASHER WALLHEAT[RS_B1_U._ M <br /> LAUNDRYTRAY UNITMEAT@RS–B.T.U, M ___ <br /> CLOTNES WASHEfI EVAPORATIVE COOLEHS _ <br /> WAiEN HEATEIi CLOTHESDRY[RS _ <br /> URINAL VENTILAiION FAN _ <br /> DRINKING fOUNTAM FAhG[HOOD <br /> FLOOR�RAIN _ ���7��ANOLING UNIT– C F.M. __ _____ ___._ <br /> VACUUM Bf7EANGRS — –_— 'STOV[ _–__ <br /> ROOFOqAINS–RNNLEADERS METALI'IREPL�C48CIIIMNf:V ___ _ __ <br /> SiNKISERVICE–�AR,ETC. WOOOS70VE/FlRCPIACE INSERT _ _ <br /> SUB TOTAL SUB TOTRL S _ I <br /> PERMIT 3 PERMIT f <br /> TOTAL FEE f TOTA�.FF.E f _ <br /> THIS PORTION TO BE COMPLETED BY BUILDING D[PT. PERSONNEL <br /> fqONIS[IOe�N �EAREFfBPCN SIOESEiBRCR PL�NGN[GNNUTABEfi PI�NCNEGNFEE <br /> �EE nECEIPiNO <br /> I <br /> US[�nvr � LOi�BE� y��pNi 51tE V�LUIITION FEE <br /> �� ❑YES ONO FEES I r <br /> iYVEOfCONSi. OCGUP�NGYGROIIP NOAfDWELUN6UNIT5 � _ <br /> Bl11LDINC s <br /> 5¢E Of OLDO NO OF SiOBIE9 M�IL OCG LO�D <br /> PLUMBIN6 <br /> MECHANICAL <br /> FIRE SPRINKLERS REOUIRED ❑VES O NO <br /> OTHER <br /> PENRLtY <br /> PPM1IIC4110NACC 9v vUNSCHECNEDBY �PPN.iORI55UANCEBY <br /> TOTl1l � <br /> � <br />