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L..PPLICATION �0..' ��� <br /> '"°E"'°'"" CONSTRUCTION 0 <br /> �:ry�F <br /> evere�t PERMIT <br /> BUILDING DEPARTMEMT <br /> 259-8745 TO BE COMPLETED IN INK- PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBIIJATION ❑ BUILDINO T�MECHANICAI ❑ PLUMBING ❑ SIGN <br /> OWNER M�ILAOOP ss cm i r�w�+e <br /> �1s�xa ����� 2�.i"�'1 l�iu.�K�.��;�i- Au� 1��{I �t�'r1' 01 ��ls� —q�3 <br /> /.RCHIiEL O�UE4�ONER M�IL/.DOIIE99 CIIY 2 P P O E <br /> OEHEa�LCONIPAGI�R MMLAOD�E55 CIfY iIP P��ONE LICEN9E• <br /> MML��ORE55 Cltt 2�P PIIONE I�CENSE• <br /> MEG��ANIQI GONtP�CiOq � 1 <br /> I} L L�LI I I1 r ' I �'✓� `� 1I�i23 I-ItQhU; �� ta�►Pl-� L��Zc�- ��3�=1'13C� 11Y-lll-�ll �ls�.� <br /> PLUMBINOC IIRIl10� <br /> M�IL�OOAE59 V CIlV 21P �IIO'IE LICENSE• <br /> GL�SS Of WONN <br /> ❑ NEW ❑ ADDITIDN ❑ ALTERATION ❑ AEPAIR ❑ DEMOLIT�ON ❑ WOODSTOVE/FRPL.INSERT BUILDINO RELOCATION <br /> `�Ulolrw� �r .s� �1E�ulSPLUSL�90n1 <br /> oescaiee woaK <br /> Tf-�`,; e� ir_Ld- � _ �ecc_-�-er .T�S��'i . - � -► cc� <br /> use or ew�ou+o � 1 HEREBY CEFTIFV THAT I HAVE READ AND EXAAIINED THIS AP• <br /> PLICATION AND KNOW THE SAMET(1 BE TRUEAND CORRECT.ALL <br /> IEWLUCSW�IPIIC`IVFPROPERtY�5110WN0ELOYlO11�liAC11fOU�COPI[51 PROVISIONSOFLAWSANDORDINANCESGOVERIJINGTHISTVPE <br /> OF WORI:WILL BECOMPLETED WITH WHETHEF SPECIFIEO HERE• <br /> i�i_eioc�—oF IN OR NOT.THE GFANTING OF A PE9MIT DOES NOT PRESUME TO, <br /> GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANYOTHER STATE OR IOCAL L�W REGULATING CONSTRUCTION <br /> OR THE P6RFORIdANCE OF CONSTRUCTION. <br /> SIONATUREOFCC�*R�GTORO��RUTHORILEDpGENT UnfE <br /> APPL Ni9Cl`Y USINE99l�CCN5Ef10 ` ���� � ' � <br /> VROJELTApCAESS /� (/�' ' <br /> 2`�� UI � l�•Y�iC� � �-'�"�,' MECHIINICAL <br /> PLUI�IBINO FEE NO. TYPE OF EOUIPMENT FEE <br /> NO. TYPE OF FI%TUflE <br /> AIR LONO.UNITS-H.P.E�. <br /> WATER CLOSET(TOILET) qEFRIGEHAT10N UNITS-H.P.EA. <br /> BAIHTU9 BOILERS-N.P.EA. <br /> �qyAT017Y IN'ASH Of S�N� ` <br /> GAS FIREO 0.C.UNITS-TONNAGE En ` �.y� <br /> $HOH'ER FORCED AiP SYSTEMS-B.i.0 EA. �'/L1 <br /> NITCHENSINKBCISP. y.q��NEATERS-BT.U. M - <br /> OISNWASHEB UNITHEPTEl75-B.T.U. �1 -- <br /> LAUNDflYTPAV EVAPORATIVECOOL'cRS � <br /> CLOTHES WASHER CLOTHES DRYERS <br /> WA1ER HEATER yENTILATION FAN — <br /> UAINAL qANGE HOOD <br /> ORIIIKIN(i FOUNiPIN ��p HANDLING UNIT- C.F.M. <br /> FLOOF DRAIN STOVE <br /> VACUUM BHE�KERS METALFIREPLACEBCHIMNEY <br /> ROOF DRAINS-RAINLEADfRS WOODSIOVE/PIREPLACE INSERT � <br /> S�NKiSERVICc-BAR ETQ) ���: G � _- <br /> .����'�p��� - — <br /> � -- , �- �-T, <br /> tueTor�< <_ <br /> SUBTO:RL — pEAMIT s <br /> PERMIT � TOTALFEE s - <br /> TOTpLFE' � <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PFRSG\NEL <br /> PL�N G11EGN NUMOER PUN G��ECR fEE <br /> REAASEIOACK �S��ESEi6�CN RECEIPiNO <br /> fnONI5E10ACN fEE <br /> USEZONC <br /> Lp1ARF.� yAGANiS�'E FEES VAlU�T10N FEE _ <br /> pYES ONU <br /> TnOF�GNSf OCLUF�NCYGROIIP NOAFDWELLINGUNITS <br /> OUILDINO s _ <br /> SilE Of B106 ��O Of SiOPIES• M�X OCG LOAO <br /> PLU�!B�"J - <br /> MECNANICAL <br /> � <br /> FIRE SPRINKLERS FEOUINED ❑YES ❑ NO OTNER __ <br /> PENALTY � __ - <br /> PLANSGMECNEOBY APPRi0Ri55lUNCE9Y � � <br /> pPPI.ICAl10N�CC 9Y TOTFI � <br /> / � � _ <br /> / <br /> ..� <br />