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..�'��..�C������ ���e <br />,�.E,.,,,..� CO�IST�tI�C���Of� <br />��erett PER,MIT <br />BUILDING DEPARTMENT <br />259�8745 TO BE COMPI_ETED IN tNK• NLEASE PRINT <br />❑ DEMOLI'fIOP: ❑ COMBINATION i� BUILOIR�G O MECHANICAL <br />pv;,�,; f�!� <br />❑ PLUMBING <br />evcrett <br />� <br />❑ SIGPS <br />OWNCf1 ` MAIIPDORCSS GIIV 21P PIIOGC <br />llrS. �(�;r_r::�'r-i %1�'<!.:"r�r:r4' 11�1<�i l�n�yi firl'. %;�,:F:':j. �b'`d�� ,�1�5'-j!�/ <br />MLMI�[CiOfi�CSi�NER IAAILAODR[35 ' GItY ��— ZIP P��O'.E <br />�^ <br />OCNEP<LCONINAC�O� IAMLAD�I1E55 GfV bP m�ONE IICENSF• <br />�-I �Rvev l-: /l/�.�»i i � ,,,, <•� , �.YL� ..�'6 iL ls' �EjVK17C 9�a7s ��� i-/S'3 � �t•'`33 F�� <br />Mer.��nu�en e��nneion uaaeooness enr zu� �vor�c ucv�s.. — <br />PLUMyIN�CONIReb�On M�ILAOORESS LIIV ZIP PI�ONf <br />UCf tl �( . <br />%e�'iCU R.Iu:�rT ,>'�;��� �u9 ra. st. ,S,t• Hiw,eer. /riA s?C' jjY'/.1.Yi— <br />c�nss � wonn�j1 <br />❑ NEW y�+ ADDI710N l� ALTERATION ❑ FEPAIR ❑ DEh10LIT10N ❑ WOODSiOVE�FHPL.INSEFi C� BUII�ING RELOC�110N <br />l'AIUAl10N OF WOBx ILOSt OF M�l(f1U�5 PLUS U00111 <br />�s i�r - � �-� �dU. ��u .� 7ak -- <br />ocscniaEwonK <br />�' x.?s txc�c'Sc,{`C Ux.It.0 tX�cT�.��e_ G.ZGCS � /� 74P4 G.i�t, Cc /.�" ,pC /CA �[�iiEn'.. <br />USL Of OtIILDING �, <br />IEG�L OESCf11PtION O� PAOPfRIY �SIIOWN OELOW OR R <br />�3 <br />'�orj � eioc�er 5�.�:� �'an'x Ad( <br />r <br />PLUMBING � <br />NO. TYP <br />J WATERCLOSET�T( <br />BATHTUB <br />LAVATORY (H'ASH f <br />S110WER <br />KITCHEN SINK 8 OI <br />DISNWASHER <br />LAJN[1RY TRAV <br />CLGiHES WnSHER <br />WATER HEATER <br />URINnL <br />DRINNING FOUNTAI <br />FLOOR DFNN <br />FEE <br />44 <br />I 11EREBY CERTIFY THAT I H^.VE RE�D AND EXAMINED TI�IIS AP� <br />PLICATION AND KNOW THE IiAME TO BE �i RUE ANDCORRECT. AlL <br />PROVISIONS OF LAWS AND UR�INANCES GOVERNING THIS TYPF <br />OF \VORK WILL BE COMPLEIED WI7FI WHE7HEH SPECIFIED HERE- <br />IN OR NOT. THE GRANTING UF A PERMI i DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS UF <br />APlY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OF THE PERFORMANCE OF CONSTRUCTION. <br />SIGNAIUFE OF CONiFACTOP OR AUTNORIZED AGENT DAIE <br />a( /,� ....,, ,/��,.1�% • <br />Flfi[D q.C. UN17S-TONNAGE EA <br />UNR NLATEPS�-B.i.11. M <br />.Tx <br />THIS POR'rION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />IPONiSCIB<f,Y RERfi!EiB�CH <br />usE10NE Lor�nE� <br />lC'�Y JU !�' <br />i�oE Of WNSI OLOJPRNGyGROI <br />.k' N %�- Z- <br />s¢e or oioc no. or sromes <br />3 $� / <br />� VaCRIi SIIE <br />OVES [`NO <br />NO OF pWELUHO UNIiS <br />O <br />Mez occ �oeo <br />RPPR FOR ISSUANCE BY <br />G • c. <br />I �J. <br />FEES <br />om�oiNa <br />PLUMBING <br />MECMPNICAL <br />OT11EF <br />PENRLTY <br />TOTAL <br />6 �°-� <br />��NI tTs <br />���l�All CI�[CN fCE ---/// <br />fEF.IC_Ir��S._.IRECCIPINO �/_,` (�� <br />��cc� � <br />VRLW110H I fEF. <br />S 22.�3D:IJ <br />� c..�t� � M�zN <br />,Q�T�.`P. <br />OU <br />