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APPLICATI�' 1 FOR CON�TRUCT �E1 PERMIT , .�*�
<br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT ���T
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<br /> HEATING SYSTEPA�. �J GAS J ELECTRIC .1 ._ _ - _
<br /> t3JILDING DEPART�<"ElJT �-- ------ � - �— --- - --'
<br /> 259-8810
<br /> DEMOLITION COMBINATION ✓BUILDING �ECHANICAL ✓�LUMBING SIGN
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<br /> x X 3, ,� . _ I HEREBY CERTIPY 1HAT I HAVE READ AND EXAMWED THiS
<br /> �'y R�d rr,ovosmuse ev ow�oiac APPLICATION AND KNOW THE SAME TO BE TRUE AN�CORF'cCT ALL
<br /> O H Lo-��_3�_[�q_ecaeed�lavr.rc.¢ �jd^ PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS T�PE OF
<br /> H �gi.[r�i�rscmm�;r�.oF raooE�rv�suowr+eeiow���:•rv.unwoccr�,o-s�, WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR
<br /> q NOT. iHE GRANTING OP A PEFMIT DOES NOT PRESUh1E TO GIVE
<br /> z N 3 ��or �3 r�.ocK or — AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANv
<br /> � y z -- _ OTHER STATE OR LOCAI LAW REGULATING CONSTRUCTION OR THE
<br /> PERFOR6fANCE OF CONSTRUCTION.THAT I AM AUTHORIZED�V THE
<br /> � y y -- OWNER OF TIi15 PROPERTY TO PERFORA1 THE WORK FOR WHIGH
<br /> p,� APPLIC ION IS MADE AND I COIdPLY WITH THE S-fATE
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<br /> � PROJECTADDR S j%� �� �._• � .—._�.-__._..., ..—r _—_- — _
<br /> �
<br /> PLUMBING � MECHANICAL
<br /> NO. TYPE OF FI%TURE OR ITEh1 FEE N0. TYPE OF E�UIPMENT FEE
<br /> � WATER CLOSET(TOILET� _ _ � _ _ A C-A NNDLG UNITS-HP.
<br /> i � BATHTUB ' _I_ FORCEDAIRSVSTEMS-BS.LL M1I E.A.
<br /> C� 'Z IAVATORY�WASHBASIN) UNITNEATERS--O.T.U. M
<br /> �' ( SHOWER f CIOTHESDRYERS
<br /> ( KITCHEN SII:K 8 OISP VENTILATION FAN
<br /> _�_ DISHWASHER � J HANGEHOOD .
<br /> , I�� LAUNDRY TRAY L WATER HEATEA ;
<br /> ��1 CLOTHES WASHER 'NOOD STOVE
<br /> —�—
<br /> URINAI. METAL FIREPLACE(WOOD BURNING)
<br /> DRINKING FOUNTAIN FIREF'LACE�NSEFT
<br /> '� FLOOR DRAIN HEAT PUM11P _
<br /> � �� BACKfLOH!PREVENTERS GAS PIPING
<br /> ROOF DRAINS-RAINLEADERS � E%HAUST FAN
<br /> SINK�SERVICE-BAR,ETC.1
<br /> —� —
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<br /> � — —. - -- SUBIOTAL 5 I SUBTOTAI S - -- —
<br /> ���. PERMIT 5 --� PERh11T 5
<br /> TOTAL FEE 5 NTAL FEE 5
<br /> FOR OFFICE USE ONLY: - � �� '�`Z
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<br /> us! •��:e iainnrn vncnNrsn� FEES VALUATION FEE
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<br /> Y—�� 2 Q=3 I PLUId01:JG �,�3 i d_
<br /> SilEOP�LIX: fw[54'nMnl[R511[ao �nSErAC4i MECf1ANICAL /
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<br /> 44o s Gna U
<br /> oCCUPANCYLOAo �inEn�ARMaEao �a�;'d.n.{u�nmm�ON ADDITIONALPLANCMECK
<br /> O I F{J� OTHER �%, I _ ' � �
<br /> n[n50N % `l'�'\ _ /i.� � '
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<br /> $TATE BWIDING SURGHARGE � �,- '
<br /> wmv[uv rims nrvNovrr,or CITY OF EVER[TT rUt7uC No�a.s � ' '
<br /> , � LOCAL SALES � � �
<br /> �",�'3 3 TAX COOE IS 3105 roT�� ', ; ; j ��
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