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a►.�,.�..� <br />ever�ett <br />259-8745 <br />� �NSTRUCTION � � _ _q r�CC <br />RERMIT PERMITNQ:_ •� TG`�`� <br />❑ OEMOLITION � COMBINATION ❑ BUILDING � MECHANICAI. ❑ PLUMBING ❑ lION <br />ox�an r.uneo ss crv na <br />Loren M. Mn C�miminge 916 Woo�awn Ave Evere�t, W1 98�03 252-57�'0NE <br />�RCHITECTOROESIONEN WILADORE55 LITY ZiP plp�E <br />GENEA�LCONTIUCTOR M�R�DORESS CITY ZIP PHpNE UCENSE� <br />Self <br />IlUll �DDBf55 <br />�DDRE55 <br />CI�Y <br />CITV <br />ZIP <br />LIGENSE • <br />21P PHONE 4CENSE � <br />CL/�SS OF WORR <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDINQ RELOCATON <br />VAL WTION OF WOPN <br />i <br />Put in woud etove <br />IEAT SOURCE <br />❑ ELECTRICITY ❑ 6A3 <br />Single family dwelling <br />2 1 <br />LOT � BLOCR � <br />916 Woodlawn Ave <br />PLUMBING <br />❑ WOO�STOVE <br />Cascade Terrace <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET �TOILET� <br />BATMTUB <br />LAVATORY�WASHBASIN� <br />SHOWER <br />KITCHEN SINK 8 �ISP. <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DFlAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS - RAINLEADERS <br />SINK �SERVICE - BAR. ETC.) <br />BLU(: <br />M.M. <br />SUB TOTAL <br />PERMIT <br />TOTALFEE <br />VRCANT SiiE <br />❑YES ❑NO <br />❑ OTHER <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PHESUME TO GIVE AUTHOFITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PERFORMANCE OF CONSTRUCTION. <br />SIGN�AjT 'RE OF CONTNACTOR/. �TNORiZED �GENT, OR OWNER ONTE <br />X ,[c�-t.._ �%J l �..,,�,�.. L. 10/3/86 <br />MECHANICAL <br />FEE NO. TYPE OF EOUIPMENT <br />A/C - A/HNDLG UNITS - MP. <br />REFRIGERATION UNITS - H.P. EA. <br />BOILERS - 8 T.U.MP. <br />GAS FIRED AC. UNI i S- BS.U. <br />FORCEDAIRSVSTEM$-B.T.U. MEA. <br />WALLHEATERS-AT,U. M <br />UNIT HEATERS - B T.U. M <br />EVAPOPATIVE COOLERS <br />CLOTMES DR1'ERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATERHEATER • <br />WOODSTOVE <br />METAL FIPEPLACE 8 CHIMNEV <br />FIREPLACEINSERT <br />MEAT Pl1MP <br />GAS PIPING <br />E%HAUSTFAN <br />NO OF DWELLING UNRS <br />NO OF STORIES � MA% OCG <br />RPPR FOR ISSURNCE UY <br />SUBTOTAL <br />PERMIT <br />B W LDINC <br />PLUMBING <br />MECHANICAL <br />INVESTIGATION FEE <br />STATE BUILDING SURCHlRG <br />STATEENERGVSURCHARGE <br />DRIVEWAV PERMIT <br />FEE <br />�-- <br />1 1 :,. S ■ / 11�.�. ' � <br />�� � � <br />�M. � .1 I,1 ■ <br />�w � �� . <br />TOTAL I I <br />PERMIT VALIDIITION <br />WHEN PROPEFLY VALIDATED (IN THIS SPACE� THIS IS YOUR PERMIT <br />ACDHESS FILE <br />