Laserfiche WebLink
r.PPLICATION FO1. <br />,".`w„""" CONSTRUCTION <br />GITY OF <br />eVE'.rett PERMIT <br />BUILDING DEPAR7MENT TO HE COM�IETED IN INK • PLEASE PRINT <br />259•8810 . <br />❑ DEMOLITtON ❑ COMBINATION l_I BUILDING ❑ MECHANICAL <br />JWUCR �A�n f1Puf55--- �v !�P- <br />��ry rff�- � �� <br />, "1v )V/cc�i�niS;GJv:t ��c7i.run� ;�uEA���r a,� <br />�nr.wrec�oaois�cu[�� un�nm+�ss / cm m� <br />evereN <br />e <br />❑ PLUMBING ❑ SIGN <br />m�nne <br />'j,�`.1�,�3/ <br />r.uu.r�ma.ss _—'—'–_--rm tir runr�r �ir.vis[. <br />GI.NlR4lLOM1FRGiO� - <br />U/A1 /iln — `--�"—��---- GII\ IIP PIIONL IICCHSC• <br />r�.lCn4MiGe1 CnNTR�CinA 61a1i applil::ti <br />PIUM1IOINrCOtlLROCIOR I.IPII eCORISs (11IY 21Y P'IOtl( IICUISf � <br />Q �c ] OI VlORM �{ <br />❑ NEW ❑ ADUrtION ❑ ALT[RAl10N ❑_ HEPAIN ❑ D61d1�U11UW Idl �40DDSTOVE/FNPI INSLHT ❑ �UILDING HELOCAIION_ <br />!' <br />W l W fION Of wOBr �fA!il O� �.�>i[ Ri4l 5 1'1 �151 aNOIU <br />Of SL/RIIBC1 1WJF <br />w �d .S� I[,� <br />usc or euu ouu; /� <br />5�.., J t; <br />ICML OESCPiP �AN O� �P <br />ioi_oiacK— <br />ao.iecuooaess <br />G q o ,�) <br />PLUMBING <br />� 1 <br />-- TYPE OF FItTU <br />W�TER CLOSET ITOILETI <br />B�TMTUB <br />UVATORY IWASH 9�SIN1 <br />SMOWER <br />NITCMEN $INK 8 DISP <br />DISHW�SHER <br />IAIINORYTRAV <br />FLOOR <br />' DHAINS – I <br />�SERVILE – <br />� NOM SEI�/.L'h <br />iis� <br />� <br />I HERC-BY CEHTIFY THAT I HAVE fiEAD AND EXAMINED TFiIS AP� <br />PIJCATION AND KNOW ThIE SA1dE TO BE TRUE ANDCORRECT. ALL <br />PROVISIONSOF LAWSANDORDINANCESGOVEFNINGTHISTYPE <br />OF WORK WILL B[ COMPLETED WITti WfiETHERSPECIFIED HERE• <br />IN OR NOT. 1 HE GRANTING OF A PERMIT OOES NOT PRESUME TO <br />GNE AUTIIORIIY TO VIOLATE OR CANCEL THE PROVISIONS OF I <br />FNY OTI IEFi STAiE OR IACAL LAW REGUI.ATING CONSTHUCTION <br />OR THC- PEHFOHAIANCE OF CONSTRUCTION. <br />blii!lAl11HLU11:UNIHOCIGRO11AlII11O11VLPTGlIU bA�f_ <br />„ -r _.//—g� <br />X i �.. .. :)/;-,� . �:� ::/_; :� <br />MECHANICAL <br />fEE NO. TYPE OF EOUIPI <br />AiC – A�MNOLG UNIT$ – H P <br />REFRIGERAtIONUNITS–HP I <br />ftOILERS – 0 T U il l P <br />GASFIREDAC UNIiS–BTU. <br />FOFCED A�H SYSTEMS – B T U <br />WALI MEAIERS – B T U <br />uNIT MEAtERS – 0.T U <br />GVAPORnTIVE COOLERS <br />CLOTNESDHV[RS <br />V[NTII AiION F/ N <br />RANGEMOOD <br />WATERIIEATER <br />� WOOOSTOVE <br />METAL FIREPLACE S CMIMNEY <br />FIflEPLAGE WSERT <br />HEAiPVMP <br />GAS PIPING <br />E%IiAUST FAN <br />SUBTOTAL S <br />PERMIT f <br />TOTALFEE f <br />FE>N SEIB�GK Slp[ S[IB�CN <br />ioranca VPL�N�Si1L <br />IlYlS IINU <br />occurnr�crcnour i�oarmvru.iscuruis <br />NO O( SiONI[5 1.1iY OGf. 104I1 <br />�rruccuou nee nv ri nru cn[enin or I.ivvi i aiuzsiuuc� or <br />, n� �\1. <br />V <br />SUB TOTAL <br />PENMIT <br />TOT�LFEE <br />PLAN �MECKNUMBER IFEE <br />DUIIDING S <br />PLUMOING <br />MECHANICAL <br />O7f1EH <br />STATE OWLDING SURCHARGE <br />5TATE ENE(iGV SURCIIARGE <br />PUdLIC WOHKS <br />TOTAL <br />M EA <br />M <br />M <br />FEE <br />NECEIPT NO. <br />FEE <br />PROPERTV L�INE LOCATE�h�'S ANDNRELATED E SEMENTISING ALL <br />