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the Everpresn ,� � P P � 1 C A T I O N F O p everetl <br />��r�. CONSTRUCTION e <br />e�erett Pf RM IT <br />DEPT. OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259�8745 � <br />EVERET7,w�5a20� ❑COMBINATION �BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />� OWM1LR� /I n MeLL�D�N[55 ^ . _. ... - CIIY� —,/ ZIV„ FHO^E� '. <br />1 <br />va ir � <br />AROIIi1R OR O[SI <br />rm <br />S��uc74.,a1 Llesyn 9csoo 5630 /58'`sd,��Ow Lvn.ru.a� ��a�L 77S-�y��! <br />GfM1EPnLCON�ReC10P M�IIAD�RL55 Cltt 21P VNONE UCENSf I <br />n�ICMA�IUlCO`�1PnCiOR MAILe��PE55 CIIY tIV PHONE lKfNSE/ <br />PIUMqINGCOHiNACiOR MAllA00NfS5 GIIY ZIP PHONF llC[NSE/ <br />IUSf Of NORK � <br />❑NEW ❑ADDITION �LTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />V�IU�LION Of KOPK <br />' � <br />OfSC. IIf NONK <br />Zn �af� e is7�' �urc:a7�,' <br />ruovos[ous� o� nuiioi�+c I HERE6Y CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />{J n� Jtd�" <br />lE Wl D6C0.1P110Y Of PROP[R1Y �S <br />LOi � 9lOCN �� Of , <br />"��5/ 9 s F_ EuP.. t <br />�LUMBING <br />NO. TYPE OF <br />WA7EF C105[T ITOLIF <br />UVATORY �WASN flAl <br />SMOWEN <br />KITCHEN SINK 8 DISP <br />LAUNORVTRAY <br />CLO7H6 WnSHER <br />URINAI <br />OftINNING �OUN7AIN <br />FIOOR ORAIN <br />VACUUM NREAKfRS <br />ROOF URAINS—RAINI <br />$INK �5[NVICC—PAR, <br />e PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />B[lOW OP ATIACM iOUN COVIF51 PROVISIONS OF LAWS AND ORDINANCES COVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIpNS OF <br />ANY OTHER $TATE OR LOCAL LAW RECULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. Q� / c' <br />SIG�RE OF CONTRACTOft O AUTHORIZED ACENT DATE/ (7'r1.� <br />�, .��� s <br />TOTAIfE <br />S�DE YARD SRIIACK STREET SLTO <br />USE LUNE LOT ARFA <br />TYPf OFCONST OCCUPANCY <br />SIZE OF NL�G NO. OF STOI <br />FIRE ZONE BASEMENT <br />APPIIOVALS <br />1 ENVIRONMENTAL CMECK 115T <br />a euaoiNc vur+s <br />) fIR[ MYONANT <br />� fIRE PRO7ECTION SYSTEM <br />5 GNAUINGII%GVATIONBCIfARINGIGRUNHING <br />6 DRAINAGF <br />L ENVINONMfNTAL IMPACT STATfMENT <br />8. HEALTH DISTRIC7 <br />�S <br />RUR VARD SFTOACK <br />VAUNT 517[ <br />�YE$ ❑NO <br />NO OF DWEILING UNITS <br />Mn% OCC LOAD <br />FIHE SPNINKILHS <br />REQUIN:D <br />flYlt f7N0 <br />BY OATE <br />APPLIGTION ACC. 9Y PLANS CHECKED BY I AFPk. FOR ISSUANCE BY <br />MECHANIUI (� <br />NO. TYPE OF EQUIPMENT FEE <br />nirs mNo uNirs—�i r. en <br />REFRIGFRATION UNITS—MP. EA <br />BOILERS—N P EA <br />CAS fIREDAC UNITS—TONNACE EA <br />FORCED AIR SVSTEMS—B.T.0 M FA <br />\VAlLHU7EN5—UT.U. M <br />❑NITNEAT[R$-13TU. M <br />EVAPORATN[COOLERS <br />CIOTHES DRYERS <br />VFNTILATION FAN <br />RANGFHOOD <br />AIR HAN�IINC UNIT— C F M. <br />STOVE <br />MFTAL FlREPUCE d CMIMNEY <br />SUBTOTAL S <br />PERMIT S <br />PUN CMCCK NUb111ER <br />FEE <br />iEES <br />PLAN <br />IIUILDING s <br />PLUMIIING <br />MECHANIGL <br />O7MFR <br />PENALTY U.00. <br />SEC. lOJlal <br />TOiAL <br />PERMIT VAIIDATION <br />WHEN P0.0PFRLY VALIDATED IIN TNIS SPACE) iH15 IS YOUF PERMIT <br />g.1-;9 �� � Ei.-. v'w fu""r✓� l7�"�'! <br />J <br />