Laserfiche WebLink
�����'-'PPLICATION FO'�;� <br />t <br />)'i <br />'°.E'.`°`"" CQNSTR�ICT�ON � <br />cirr oF <br />�verett PERMIT <br />EUILDING DEPARTMENT TO BE COMPLETED IN INK • PLEt�SE PRINT <br />259•8810 , <br />: C DEMOLITInN ❑ COMBINATION � BUILDING '••� � MECHANICAL <br />N <br />❑ PLUMBING <br />PMONE <br />a �.. --� <br />PHONE <br />cvereH <br />e <br />❑ SIGN <br />PWMBIN7CONiH4GtOR MRIL�ODRE55 CITY Z�P P��ONE LICENSe• <br />NEWV ❑ �DDI710N ❑ ALTERATION ❑ HEPAIR ❑ <br />�TIONOFWO�N�WSTOFMRiEflI�LS��BOR�� � <br />�� <br />OFBl�01NG '''. A_ � <br />n <br />PLUMBING <br />NO. T' <br />WATER CL( <br />BATHTUB <br />UIVATORY <br />SHOWER <br />KITCHEN S <br />DISP. <br />ING FOUNTAIN <br />i DRAIN . <br />°LOW PPEVENTERS <br />DRAINS - RAINIEAD <br />SERVICE - BAR. E7C <br />SU9 <br />�O / <br />-a� <br />AIIOH PC B� <br />ITEM <br />OTAL FEE <br />SETBACK <br />� � <br />:Y Gf10UP <br />�-s <br />ORIE3 <br />Z <br />IT SITE <br />ONO <br />° OWELUN� <br />� <br />)CC LORD <br />�I� <br />CHECI(ED BY �PPN. FOR ISSU�NCE <br />f� G •� <br />❑ BUILDINO RELOCATION <br />� <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl <br />PROVISIONSOF LAWSANDORDINANCESGOVERNINGTFIISTYPE <br />OF WORK WILL BE CC'�APLETED WITH WHETHER SPECIFIED HERE• <br />IN OR NOT. THE GRANTING OFA PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTP.UCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. g n <br />IGNAT E OF CONTRACTOR OR AUTHORI2E0 AGENT DATE IO `�/%} 7 <br />APP�ICRNiSCITVBU51NE55LiCENSENJ - <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT � <br />A/C - A/NNOLG UNITS - H.P. <br />FEFRIGERATION UNITS - H.P. EA. <br />BOILERS-B.T.U./H.P. �.1�. <br />QASFIREDA.C.UNITS=@T.LL � <br />FORCED AIF SVSTEMS -B.T.U., '� M EA. <br />WALLHEATERS-B.T.U. M <br />UNIT HEA7ER5 - B.T.U. M <br />VEf�TILAT�ON FAN <br />RANGEHOOD <br />WATER HEA7ER <br />WOODSTOVE � � <br />METAL FIREPIACE 8 <br />PIPINO <br />1USiFAN <br />M <br />- I TOTFL FEE q -T� <br />�.1-�• <br />PLAN CHE K NUMBER pEE � 2/i RECEI�NO. � O' <br />gr7 iqOy9 �f =- � <br />FEES VALUATIOtd FEE <br />euaoiNc 5 s��j ' <br />PLUMBING <br />MECHANICAL <br />� OTHER <br />STATE 6UILDING SURCHARGE <br />STATEENERGYSURCHARGE <br />PUBUC N�ORKS <br />TOTAL <br />PROPERTY LOINE LOCATIONS A DNRELATED EASEMENTIS NO ALL <br />