Laserfiche WebLink
IM Ew�prNn <br />�,n a� <br />�verett <br />BUILDING DEPARTM�!JT <br />259-8745 <br />`�y'PPLICA�'10N EC1►1 <br />�ONSTRUCTit���J <br />P�RMIT <br />TO BE COMPLETED iN INK- PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHtiNICAL ❑ PLUMBING ❑ SIGN <br />pWr1EP MAILADORE59 Clrv ZIP PHON[ <br />�� <br />F�� - � r? r�� P9 ar eha�l �' 9% 3.� �(o� Se-a�/r.9s�io<% "', ��f� a�7o - <br />�•fiG�1UlEC10PDE510NEfl MAILADORESS Qtt 21P PHONC <br />_j„J' �' ; n �r'_�n(- <br />�G[LER�LCO�n�GIOR M�i�ApORE55 CITY 21P PHONE 4GEu5E• <br />/1 /}��3� /�i i��i• t i3Gio,n� d.z .�r :F Ei/e.�G�% �A".2n:� %/J" il:i<i r�L�C'/"�il�i�-'� <br />M6CNANIGL LOf OnLTOR MMt ADORE95 CI�Y ZIP PIIUNE LICENSE • <br />PWMBINf]CONIN CIOR M�ILADDiiE55 CITY 21P PIIONE IICENSI • <br />CIASSOf WOfiN <br />❑ NFW ❑ AODITION � ALTERATION ❑ FEPAhi ❑ �EMOLITION ❑ N'OODSTOV[/FFPL�NSERT ❑ BUILDING FELOCaIiON_ <br />VFIWIIONOI WONNICOSiOf M�IEf1UL5PWSlRBOR� <br />�/�"voo � <br />OESG�iOE WOOR T _ _ — ,�, <br />LEWL <br />� <br />sE�orcK <br />NK8 <br />- bF�� c.-, cd �il � � 7or� <br />� I HEREBY CERTIFY THAT I HAVE READ AND EXAtdINE� TIiIS AP� <br />- 8 PLICATIONANDKNOWTHESAMETOBETRUEAIJDCORRECT.ALI <br />ISHOWNUF.LOWORRIT�CHi0l1RCOPIES� pROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br />OF WOFK WIIL 8[ GOIAPLETED WITH WHETHER SPECIFIED HERE- <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITV TO VIOLATE OR CANCEL THE pfiOVI510NS OF <br />ANY OTHER STATE OR LOCAL LAW REGULAi�NG CONSTFUCTION <br />OR THE PGRFURMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONiMC10R OR AU1110P4ED FGENi DT1E <br />3 <br />NO. <br />EA. <br />`J3CED AIR SVSiEMS—B.T.U. AS EA. <br />WALL HEATEFS—B.i.U. M <br />JNITHEATERS—B.T.LI. Ai <br />TOTAL FEE S �__ I 1 I �`+'n� �" <br />THIS PORTION TO E3E COMPLETED aY BUILDING DEPT. PERSG�INEL <br />U51. 10�lE <br />G -/ <br />iYf�C O� CONSi <br />T-N <br />pN ACC OV <br />1 '� ' <br />SIDESEiUALK �PLAN <br />�v.9 NR- <br />W': A�E� VRCANT ItE <br />�� ❑YES�O <br />OCCUPnNGYGIIOUP NO.OFpWEILINQUNRS <br />8 •2 --� <br />110.OG SIONES MA%OGQ LORD <br />/ <br />aED ❑ YES� NO <br />PLANS GIIECHED BY AFPA. FOR ISSUANCE OY <br />� <br />L-c <br />�' G �/ 7S3['� <br />FFES <br />euaoiNc <br />PLUMBING <br />MECHANICAL <br />OiHER <br />PENALiY <br />TOTAL <br />PLAN C��ECrc V"EE <br />rfe I �" .3/� nE�rirr=Ly <br />,� <br />VRLUI.TION FEE <br />sis000 a lr, <br />