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`�.+PPLICATION FO�' <br /> everett CONPER UCTION °`e <br /> GN OF <br /> MIT <br /> TO BE COMPLETED IN BLACK INK— PLEASE PRINT <br /> BUILDINO DEPT. <br /> 269-8745 ❑ COMBINATION ❑ BUILDINO � MECHANICAL ❑ PLUMBINO ❑ SION <br /> OWHER M�ILIIDOPEDH CITY iIV PNONE <br /> l�ANr�¢E ItiIC> -dZ�ll I�o `� �ya.l d�7 i.�`irJnl 9Y_:CBto 'I•'t�{ -cx�it�S <br /> •PCN�I[CTOIIO[lIONfA M�IL�DORE!! CIIY IIP PHONE <br /> L.�.�. <br /> OENERALCONIR�GIOR M�IL�DORE9! CIIY ZiP PNUNE LICENlE• <br /> F1Jt.FL . �AJL. IW '`J�C�In <br /> MECN�NIGlCO IMCIOfl M��L�DORE!! CItY LIP PNO4E IICFNlE• <br /> f�lLV CJ�lFl4JY 4��J�^/�7 l�1CJ K_�'yQ V� I�Y NN `�W�10��'� '4 1(� ��C i� <br /> PLUMlINOCONTR�CTOA M�IL�ODPES! CITY IIP PIIONE L�CEHS• <br /> LL�990F WpRlt <br /> I� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSiOVE/FRPL.INSERT ❑ BUILDINO RELOCATION <br /> V.1 W11110N Oi WORN�COlt Of M�t[AIeL�PLU9l�B01ry <br /> �SS, � .K� <br /> OElCR�lE YIORK <br /> - Ear '�.> r:s �✓ u . <br /> u e or ewion+a <br /> I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS AP• <br /> �ET �' �� PLICATIONANDKNOWTHESAMETOBETRUEAND;ORRECT.ALL <br /> lE0�l0ElCRIPIIONOfPROVERtYIlNOWNBELOWON�TT�CNiOURCOPIE& PROVISION90FLAWSANDORDINANCESOOVERNINaTHISTYPE <br /> OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEHE• <br /> �or_e�x�or IN OR NOT.THE QRANTINOOF A PERMIT DOES NOT PRESUME i0 <br /> OIVE AUTHORITV TO VIOLATE OR CANCEI THE PROVISIONS O� <br /> ANYOTHER STATE OR LOCAL LAW REQULATIN6 CONSiRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> � SIONAtUPE OF CONTR�CTOR OR�UTHOflIZED�OENT OAIE <br /> x1�.Pb�7a/�,2 �' (1 -�-2�5 <br /> PNOJECI�OORE9H �PPIIC�NTB CITY BU91NE99 LICEN9E NO <br /> �� L- _3i r..lo R D. <br /> PLUMOINO MECHANICAL <br /> N0. TYPE OF FIKTUR[ FEE NO. TYPE OP EOUIPMENT FE! <br /> WATER Cl09Ei TOILEn AIR CONO.UN179-H.P.EA a:�2 � <br /> BATHTUB REFRIOERATION UNI79-H.P.E�. <br /> LAVATORY W�9H BASIK BO�LERS-H.P.EA <br /> BHOWER OAB FIRED AC.UNIT9-TONNAOE E0. <br /> KITCHER 91NK i DISP. FORCED AIR 9YSTEMS-B.T.U. M EA. <br /> DISHWA9MER WALL HE�TER9-B.i.1/. M <br /> UUNDRYTRAY UNITHEATER$-B.T.U. M <br /> CLOTHES WASHER EVAPOHATIVE COOLERS <br /> WATER MEATEII CLOTHES DRYERS <br /> URINAL VENTIlAT10N FAN <br /> ORINKINO FOUNTAIN RANOE HOOD <br /> F10017 DR�IN AIH HRNULINO UNIi- C.F.M. <br /> VACUUM BREANENS 5TOVE <br /> AOOF�MINS-RRINIEADER9 MET�L FIREPLACE 8 CHIMNEY <br /> BINN 9ERVICE-BI1R,E1C. WOODSTOVE/FIREPI�CE INSERT <br /> 8UB tO7�L BUB TOTAL t .%� � <br /> PEIIMIT • PERMIT � �� <br /> TOTAL fEE / T0TI1L FEE � <br /> THIS PORTION TO BE COMPLETED BY BUII_DING DEPT. PERSONNCL <br /> iPON19EiBACN PE�R9EIB�CN &DE 9EIB�CK PI�NCNEGMNUMBEP PI�Nf.nECMfEE <br /> iEE �ECEI1'1 NO <br /> USESONE LOI�pE• y�C�Nf!IRE <br /> pYE! ONO Ff[� Y1W�t10N F[[ <br /> TYPEOitONl1 OCGUPIHGYGROUP NO.OfOWElLN0UN118 <br /> BUILDINO 3 <br /> 9i2E Oi Bl W NO O!910f11F! M�K.OCC IO�D — <br /> PLUMBINA <br /> MECHIINIC�L <br /> FIRE SPqINKLERS REOUI(7ED ❑ V[5 ❑ NC — - <br /> OINER <br /> PEN�LiY — <br /> •PPUC�IION�CC OY PI�IISCIIECN[UBY APPp fOP199UANCEBY — <br /> TOT�L <br />