Laserfiche WebLink
,� <br />' I�s EwrprNn <br />cin oF <br />Pverett <br />0 BUILDfNG DEPT. <br />259•8'/45 <br />A:'PLIC/�1TIUN FOR� everetl <br />CONSTRUCTION � <br />RERMIT <br />TO BE COMPLETED IN BLACK INK— FLEASE PRINT <br />COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />MAIL ADORES$ C�Iv 2iP �uI�NE // <br />�_;7c� c-.,,-.,.,,.��., �.,H,•NTr �is�7,-,'?. �v:.>"�-7•S3? ._ <br />C�1Y LIP 1'110NF <br />CI1Y ZIP PIIONE <br />��ry , =�P PNONF <br />SE • <br />[NSE � <br />ENSE • <br />:uss ur n'ur+x <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION <br />.0 u�nnu nr u.TiON�COSi Oi M�1EAInLS PW$ LABORI <br />u� <br />wr_ <br />Op <br />� <br />ee�ow <br />� I HEREBY CFRYIfY THAT I HAVH READ AND EXAMINED THIS AF- <br />PLICATION AND KNOW TFIL SAMH TO BF �RUE �NDCORRECT. ALL <br />rouncor¢s� pROVISIONSOFLAWSANDORDINANCESGOVERNIWGTHISTVPE <br />OF WORK WILLBECO�dPLETED WITH WHEiH[RSPECIFIEDHERE <br />IN OP. NOT. THE GRANTIN(; OF A PC-RMIT DOES NOi PRGSUME TO <br />� GIVt %�UTHORITY TO V'OLAlE OR CANCEL THE PROVISIONS OF <br />ANY OTHER 51:.f E OR LOCAL LAW R[GULATING COIJSTRUCTION <br />� OR �TIJ- E PEFiFOPMANCE OF CONSTRUCTION. <br />SIGNATl1RE OF COhYrHACIOR OR AUTMOfjKE[}-AGENT OFTE <br />�/�CLKX C <br />OUSW[55 <br />'•NO. 1 '---'—.' TYPE OF EOUIPt1eHT—___--.__.. — _ _' —_FEE _-- <br />_.T' AIRCOND_UNITS—HP EA -- - __ '__'_"__ �U <br />___.'__'_'"_"___""_..___ <br />L <br />_ <br />flEFRIGERA�ION UIIIi,^�—H P. EA. _. _ . ____"'_ ___"'_' <br />._.._—_ ._ _ -__._'__ _.'_. —.— _.._ _ _ . <br />—'�'�� OOILERS—HP. [A. —' <br />(:AS rIRED AC. UNIiS—TONNAGE EA__._ ___ _ __ — <br />-� 7CEDAIqSY5iE1d5—Bi.U_MEA._____._ _____ _._ <br />'. — <br />_ . <br />WALL HEAlERS—� T lL ___M' _ _'_ _""_ _. . .. ._. _-_ _ _ .._ —'— <br />'__ . '_____" <br />_ _ . UNII HCATERS_Oi U _.A1 .._..._ _..._. _. _ . ._. __. _ __. .._____ <br />EVAPORAINC COOLERS ._"___ ___ _' _ __"._ __"'_"_... ._.- ' ___ <br />i <br />_'__'"'.—__"—" ___""— _ _ _. <br />SUB TOTAL (D IPJO _ SUO TOTAL _ , ._s _ _ <br />EXJ <br />� PERMIT f PEBMIT ,5 , <br />' ___ _ — _ . _' _ �� <br />__ <br />TOTALFEE S __�CP � , TOTALFEE _ S ____ 1EL/ <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />�qONiSEf CN RE�RSEi9 K SIOESEIORC VLANLHEChNUMpL1i PLI.t1U�I�.NfiE � <br />N� N N� _ <<�yd �`� `E S;� 33 ,�«�'7�t�.�/ <br />USE 20N[ LOTARE� yqC�NT Sii� FEES V�LU4TION FEE <br />' G � f� DVES f0iG0 <br />frcfOFGONSt OGWP���LYGROIIP NOOFpWELLINGUNli3 __ <br />`�— I+�R 82 N� auaoiN.; s/O�-� 80 'SD <br />5�1E Of pLDG NO.OF STOPiES M�K OCQ IORD �� DO <br />��� 5.F I JZ PLUM1IFING _ ___ _ <br />� <br />NECN'.D BY <br />�k1n'� <br />G•�• <br />MECMANIGAI. <br />OiHER <br />PENALIY <br />pY — <br />1'OTAL <br />r�25� <br />�� <br />�' I <br />