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ACONSTRU�CTIONR <br />�n. e..ro,..o <br />pT OF <br />ever�ett PERMIT <br />BUILDING DEPARTMENT TO BE COMPLETED IN INK • PLEASE PRINT <br />259•8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL <br />D G*r Dr <br />owr.En S+�'j�GM �Yiwi.tiG��css <br />� a,._..�., r ►�.,. t.✓ _9�a'7 Ili G��/�� dUO,n°�f/y <br />❑ PLUMBlNG ❑ SIGN <br />���N[ � I <br />; -� ��r �,. ._- <br />� MEGM�NiC�L CONiR�G 011 M�4 ADDA[59 � <br />I CI�Y Z�� ���ONE IICENSE • <br />� PW��B�NGCONIN�QOA <br />M��I �DUUESS <br />� �J'NEW ❑ ADDiT�ON ❑ AUEPATION <br />y vKu�����orwOaKicoSloru�*EmLL9�Lu5UnOAi <br />� IO00 <br />1 OCSGRiOC WORn �/ <br />� ./ �2 s P/ .!' s ��rtR �e�. <br />? use or eu��o�Nc <br />�� Sr�f/lG+� +efSiO.GOc� <br />IEO�L OESCRU9i0�! O� �AOPERfviSNJWN BELOW O 1 <br />. -r �'7 � <br />� or <br />to�B�oC�y-�-1- . <br />� ecdv� - - <br />'� PLUMlING <br />� TYPE OF FIl[TU <br />y NO. <br />� W�TER ClOSET �TOILET� <br />� <br />� B�Tti7U0 <br />�/1V11TORY IW�SH BASINI <br />�i SNOWEN <br />�' NITCHENSINN8015P <br />���� _ <br />+ ^�SMW�SNER <br />5 <br />j UUNDRY TRAV _ <br />j �RIN�L <br />•1 Dp�NKING FOUNTAIN <br />� fIOOR OR�IN <br />BACNFLOW PREVENTENS <br />� ROOF DAAiNS — Ap�NLEAO <br />� SINR ISEA�ICE — B�R. ETC <br />f <br />SUB <br />� <br />pER <br />TOT <br />SPONi5Ei9�CK RE�RSE <br />nv[ <br />5�2E <br />ePCUG�IION�GG Bv <br />�� ,1V `' <br />REPAiR ❑ DEMOLIIION ❑ WOOOSTOVElFRPL.INSERi ❑ BJIl01NG AELOCA710N <br />I HEREBV CERTIFY THAT I HAVE READ AND E%AIAINEO THI.S AP� <br />PLICATION AND KNOW THE SAME'i O BE TFUE ANDCORRECT. ALL <br />PROVISIONS OF �AWS AND OHUINnNCESGOVERtJING TNIS�iVPE <br />OF WOFK WIIL BE CCMPLEIED WITH WHETHER SPECIFiED F�ERF- <br />IN OR NOT. THE GRANTING UF A PERMIT DOES NOT PRESUME TO <br />GI'J[ AUTHORITY TO VIOLATE OR CANCEL iHE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUOTION <br />OR THE PERFORMANCE OF CONS7FUCilON. . <br />SIGN�IURE Of GONiq4LiOR Oli LUTNCIi12E� �GENi DRTE <br />X �i .4_�- ��, � R� <br />---�_—. �.. ..«..,. <br />MECHANICAL <br />; pp ITEM FEE NO. T'VE OF EOUIVMENT <br />A/C — A/MI.JLG UNITS — M P <br />REFRIGEAATION UNITS — M P. EA. <br />0011ER5—BTU/HP <br />GAS FIREO A C. UNITS — B T U <br />FORCEU A�R SYSTEMS — B TL. M <br />WALLHEATERS—BTU. M <br />UNIT NEATERS — � T-�1 M <br />E�APORATIVE COOlEF7$ <br />CLOTHESORYERS <br />VENTILATION FAN <br />RANGEHOOD <br />N'ATE� MEATEN <br />WOOD STOVE <br />ERS <br />METAL FIPEPLACE A CIiIMNEY �� <br />1 <br />FIREPIACE INSERT <br />HEATPUMP _� <br />CAS PIPING ��. <br />E%NAUSTFAN <br />�PE� <br />Or <br />FEE <br />SUBTOi�L s <br />3 PCRMIT <br />I TOT�LIEE � <br />y �' rn I RECEIPT NO <br />__ - �{+�AN GNECK NUMOEH I FEE <br />y�C�Ni SiTE <br />pYES ONO <br />NO OF DWEI <br />fORi55UaNGEO� <br />�UILDING S � <br />PlUM01NG � <br />MECHANICAL <br />OTNER <br />�� : <br />g7A7E DUILDiNG SURCHARGE �_, <br />��— <br />STATE ENERGY SUACHAtiGE <br />PUBLIC WORKS <br />l <br />TOTAL <br />PROPERN OWNER4 ARE RESPUNS�BLE FOR DETERMINING A�� <br />FROPFRNLINEI TIONSPNDREIATED,EASEMENTS. <br />