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m. ew,p�«� <br />Citt oc <br />ever�ett <br />BUILDING DEPARTMENT <br />259-A810 <br />LAPPLICATiCf� �lON� <br />CONS�'RU <br />PERM.�T <br />TO BE COMPLETED IN INK- RLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION G�BUILDING (� MECHANICAL <br />MAII P�[)II155 I:IIV lil` <br />ow�E� � 3 Z5 L3`-1 {y% S•�J. t�J��1DS Ci t� <br />� ��y ldU'..f� �l , <br />�PLUM1�181NG ❑SIGN <br />vno,.r <br />�'-1 b 63 e�3 <br />rrron•c <br />wnwi�c�•••. _�rv`C Q�N%�li`/ � n. :n• r�'.ONt L6Ef�5E • <br />GENEP�L LOMR�C1011 <br />I.UiI aPtlfl[55 <br />11 .... nr r;�on[ uccr�s[ . <br />m <br />CU550� wunn <br />❑ NEW ❑ �DDITION � ALTERATIUN <br />veiunuoH �r wonn icost or r.urznuis �`urs umn� <br />❑ REPAIR ❑ D� �•����-�t�U�� ��VOOD570VE/fRPL.INSEf±i ❑ PUIIDWG RELOCATION <br />/� <br />� � � �v __. ---- �r�ror�� . <br />oescnme wan+ CtN (J,tLN4�� <br />/1L'CEfUI"i�i°^1 t� 5"1v�W �PAR."IM.�Nt Ih/_La`•C_c�'_ �.�./Y�i w2.1� <br />useoromiuwc � • i;tERLBV CFR11fV 1HAI I FIAVE REnD AN!] EXAMINED—����s� <br />L' ��!- ��l�v�U _ PLICATIONANUKNOWIHESAI-1ETOBF.TFlUEANDCORRECT.ALL <br />� PROVISIONSl7fLAWSANUO(7.)INANCESGOVERNING1HISiYPfl <br />LEc�toEScaivliONo�nnOPEP�r�Sr�owNn(.lowOlt nAC��r�nCo�•�FF� <br />L/� OF WORK WIL.LBECOMPLETEC WITH V/HETHERSPECIRED HERE <br />����Z� ��L241 '71�7 6Y� ��- U'�`� IN OR NOT. 111E GRAN��MG OP A PERMIT DOES NOT PRESUME TO <br />ioi�o �� ' ��00— � '�JI z GNE AUTHORITY TO ViOIATfI OR CANCEL THE PROVISIONS OF <br />�i � � �IO�UY�- 3_UC S_L�S ��' JZ �N�n7�{[I75IAIFORLOCAI.LAWREGULATINGCONSTRUCTION <br />Jl°%�i ('/ I�^ —i- OR iNE PERfORIdANCE:OF CONSTFlUCTION. <br />(�, 1����(+ (l� ��M�M.Ib s�:,r�nmm.o� m�•uca.nnat:n��nizrt�ncnn nn�e <br />r-n ,tn(} � -i ' x (_� '�"t(=J ""l1 '-�—� f � J�� <br />. � � <br />� <br />rao�ecrnooaes <br />-Z3l ' �; <br />PLUMBING <br />NO. TYPE Oi' FIXTURE OR ITEM <br />� WATER CLOSET ITOILET� <br />BA7MTUB <br />� LAVATORYIWPSMB�SINI _ <br />SI IOwER <br />NITCHEN $INN d OISP � <br />OISMWASHER -__ <br />LAUND�YTR�Y <br />CLO7NE5 WASMER <br />UR�NAL <br />----- <br />DRINNING FOl1NTAIN <br />F100� O�AIN <br />9nCKFlOW PREVENTERS <br />ROOF DRAINS - Ap�NLEADERS <br />' SINHISEnVICE-�/�.ETCI _ <br />vnoHi SE�B��Lx <br />Z�l��'� 20� <br />USC �iO7NF <br />l�-� � <br />lvnE Oi CON51 <br />n��c�nT���J <br />S4E O� lilDG <br />���n�� xUU��3 �; <br />SUBTOTAL <br />veara�r <br />TOTALFEE <br />HUP SE�BACM <br />/.� <br />l01>RIN O� <br />��� ]1�� , . <br />ocur��� ��� <br />NU U SIOP� 5 <br />i '> <br />1 <br />MECHpNICAL <br />FEE NO. n'PE 0= EOUIPH <br />� A�C-A�H�I�LGl1NIt5-HP <br />REFfi� �G�nTION U1JI!$ - H P E <br />r F301LE(15-OTV�N�_ <br />� GASR��E�4C UNI':5-B.TU <br />FORCED Mf1 SYStE M?� - 0 T U <br />W�LI��ENE�S-!1 : U <br />UNIi P�[4TEf15 - D T V _ <br />LVnPORn�IVE COOLEf15 <br />CLOTMES OfiVERS <br />ver+mnno�+rorv <br />MNGE HO00 <br />� WniEf7liEATEfl <br />WOUDSTOVE <br />MGTAL fIRF.PLA� <br />FIfiEPI ACE INSf:fiT <br />NEAIPUMP <br />GAS PIPING <br />E%HAUSTFAN _ <br />�S <br />sme sciena <br />� -�IGd <br />flRf SI RINNLEHS RCOUIREU �1 VLS 1�N0 <br />Ot� At.f. Ilv <br />VAC�N1 SI�L <br />nres �ao <br />r,p or ow l� <br />M�t flCf, LO�U <br />u� Z <br />er �errnronissuuu:i <br />SUOTOTAL <br />PERMIT <br />TOTRIFEE <br />P�nrv CI ECN IJUMBER FEE <br />��s�;�o�f5�7 `I <br />FEES VALI <br />BUILDWG/p�r� �. g��J� <br />PLUMOING <br />I MECH�NIC�L <br />o,��E� <br />5TA1F DUILOWG SUf7CH�fiG <br />STnTE ENFi1GY Stl(iCMARGE <br />P';dIIC WOfiKS <br />� � — TOTAL <br />��/ I <br />PAOPERiV O�:'NERS ��� ���5�'��JSIBLG fOR �[1[f7���INING FLL <br />,�/J�: n��Nl,r f".� ,� •�� �OJBC.,C PROPEPTYLMELOCNIONSnNU��LATED[�SEMEI:TS. <br />�� r � �f <br />�jt�(LG' 1r�^2EC 1.a17H�.aT rc9�AtM�7' WA-5 <br />.. Qo�JiT �� � — <br />M EA <br />M <br />M <br />�� I RECEIPT NO. <br />I !1"l/ <br />0 <br />� <br />( <br />J <br />