Laserfiche WebLink
!M Er+ryn�n <br />cT•Y Of <br />wverett <br />BUILDING DEPARTMENT <br />259•8810 <br />r.PPL�CATION FO�;� <br />COPVSTRUCTION <br />PERMIT <br />TO BE COMPLETED IN INK- PLEASE PRINT <br />eYRetl <br />� <br />O DEMOLITION ❑ COMBINATION 0 BUILDING ❑ MECHANICAL ❑ PLUMBING ' ❑ SIGN <br />OWHER MAIL�DOFE53 � Gltt ZIP . PNONE " ' ' <br />%�dllf,c�s� f�/ �a,P-ii �/ �3a SC %7'lQ�i.ror� �v�`e�y� 9P�vo s �Sa aR/.f��, <br />�ENEMLGONTR�CTOH M�ILApOBE55 Cltt ZIP OHOIIE LiGENSE• <br />� O�i�%�h <br />' MECN�NIC�LCONTMCTOq MAI��DDPESS CiiY '. 21P PHONE �, - � �ICENSE• <br />PLUMBINOCONTRAGTON M�IL�ODRE53 CITY 21P PMONE 4CENSE• <br />CL�880F WORN <br />❑ NEW ❑ AD�ITION ❑ ALTERATION ❑ FEPA�R ❑ DEMOLIiION ❑ WOODSTOVE/FRAL.INSERT ❑ BUILOING RELC1'ATION <br />V�L W TION OF WORN �COST OF M�TERI�LS PLU9 L�BORI '� � <br />WORN <br />wc�rsww� � -/ <br />"' S:in 4/o U'�✓ e/�ih <br />rnwecreooqEs9 <br />� �3�l� �4o��on� �dore%%�—�f/a�, <br />v�uMeiNc <br />W�TER CLOSET <br />KITCMEN SINK 8 DISP. <br />' ' BACKFLOW PRhVENTERS <br />ROOF DRAINS — RAINLEAOERS <br />SINK ISERVICE — 6AR, ETC.1 <br />CONST. <br />OF <br />WC�NT SITE <br />OYES ONO <br />oca iono <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAM E TO BE TRU E AND CORRECT. A L L <br />PROVISIONSOF LAWSAND ORDINANCESGOVERNINGTHISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE- <br />IN OR NOT. THE GRANTING OFA PERMITDOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />A?IY QTHER STATE OR LOCAL LAW REGULATING CONSTFUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. . <br />SIGNATUREOFCONTRACTOROHAUTMORI2EDAGENT OATE <br />� <br />�9� `�Y�,�.,7: � <br />APPLIC�NTSGIiYBU51NE95LICEN5EN0 / <br />MECHANICAL <br />NO. TYPF. OF EOUIPMENT <br />A/C — NMNDLO UNIT.4 — M.P. <br />REFRIGENATION UNITS — H.P. EA. <br />BOILERS -- B.T.U./N.P. <br />GAS FIRED A�C. UNITS — B.T.U. <br />FORCED AIR SV6TEM3 — B.T,U. M EA. <br />UNITHFI.TERS—B.T.U. M <br />EVAPORAT:��E COOLERS <br />CLOTMESCHYERS <br />VENTILATION FAN <br />RANGEHO00 <br />WATER HEATER <br />WOODSTOVE <br />METAL FIREPUCE 8 CHIMNEV <br />FIREPLACEINSERT ' <br />NEATPUMP <br />OAS PIPINO <br />E%MAlIST FAN <br />EUlTOTAL <br />P[pY1T <br />TOTAIF[[ <br />PLAN CMECK NUMBER I FEE � HECEIPT NO. <br />BUILOtNG S <br />ttUMBING <br />MECHANICAL <br />OTHER <br />STATE BUILOING SUFCHARGi <br />STATEENERGYSURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />PROPERTY OWNERS AFE RESPONSIBLE FOR DETERMINING ALL <br />PROPER7V IINE LOCATIONSAND RELATED EASEMENTS. <br />