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'�APPLICATION FC��t everetl <br /> Ine Everpnen C O N ST R U CT 1 O N 0 <br /> cirr oF <br /> evet•ett PERMIT <br /> TO BE COMPLETED IN BLACK INK- PLEASE PRINT <br /> BUILDING DEPT. <br /> 259-8745 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNEII MRILROORE55 CIfY 21P PIIONE <br /> DAVID W �A1cEK {�U l�pc 2�(rA- �.y�vNwouu �18�3(p 79�2-783U <br /> w+�wcu.oaoesicv�n n�nanooness citt ..m Prwr+e <br /> �UNNn C ��ctl� �O.�u� 7�la� ��/NNwuUD ���3(n 742-7B30 <br /> cer+cnn�coe�n.cron MAanooncss citt nr rr�oHe ic[nse � <br /> 1s 4 �y�vNwooa 9�3(r 74-2-7�3U Dw�3nKn �' <br /> �.W .�AKE{z E � Stk_i�11:S �.1��2.2(D /�2 MC. <br /> MF.GIIAN�CAICONIRAG10fl MRIL400RES5 CIT'� 21P �IIONE UCENSG• <br /> PLUTAOINGCONIPRCIOR MAllp0�PE55 LIIY 21P FNONE UGCNSE• <br /> C�1.�{5$D�\VO�N <br /> pl NEW ❑ ADDI710N ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTU�'E/FRPL.INSERT ❑ BUILDING RELOCATION <br /> . vnwAnqj+oo �oo U��I[f11PL5FLU5LRpOR) <br /> I��� <br /> OEECf110E WOfiN <br /> 1�ev� C nS` uc� <br /> useppS�tt'o,m�oiN, l I HEREBY CFR7IFY THAT I HAVE READ AND EXAMINED THIS AP� <br /> KeS�cICr�\��I PUCATION AkD KNOW THE SAMETO BE TRUEANDCORFECT.ALL <br /> imA�ocScmrnoNovvnovcmr�s�wwr�oeiowon�ttacnrouncoriesl PROVISIONSOPLAWS�NDORDINANCESGOVERNINGTHISTYPE <br /> �� 5 \, � N�� • �p� OFWORKWILLAECOMF�FTEDWITHWHETHERSPECIFIEDHEHE- <br /> i��_o�o��_o� � Ever�. INORNOT.THF.+iRANii'?GOFAPERMITDOESNOTPRESUMETO <br /> Lt1 , GIVE AUTHORII f 70�'OLATE OR CANCEL THE PROVISIONS OF <br /> WeS'\ "t�t 61-4hc.��S�h Z�� a� Lul � -ICL'jC� W"� OR T�HEHPERFORNA�N E OF CO STRUC7 pNNG CONSTRUCTION <br /> -t� �j��' �dI ul l.O� ��1 1✓1 tJ1pC� J �f��Q �1 SIGN'.:UREOFCO'ITRAC�OiIOPRUt1/ORIiEDAGENT D47E ��y/js'� <br /> ° ^ L I I ��3 w .51�. X �,AN����3r.�uv <br /> � � 1c�c�i�lUn� J �Vl'Ycll YQfAt�c-d�1�1 <br /> Pf10JEG1�0U11E55 APPLICANTSC 'OUSINESSLiGEN5EN0. <br /> 35 31 - �hor�f ���rec� <br /> PLUMBINO MECHANICAL <br /> �, TYPE OF FI%TURE FEE NO. _ TIPE OF EOUIPMENT — FEE <br /> WATERCLOSET�TOI�E7) CL (� AIRCOND. UNITS-H.P:EA. <br /> y BATHIUB Q� REFRIGERATION UNITS-H.P.EA <br /> 3j LAVA70RV(WASH B�SIN) BOILERS-H.P.EA. <br /> S�{Q�yER GAS FIRED AC.UNI15�-10NNAGE E0. <br /> . � KITCHEN SINNB DISP. � FORCED AIR SYSTEMS-B.i.U. M EA. <br /> . DISMWASHEP CYJ WALLHEATERS-B.7.U. M <br /> IAUNDRYTRAV UNITNEATERS-B.T.U. M <br /> C:OiHES W�SHf.R L7U EVAPORATIVE COOLERS _ <br /> � WATER HEATER � CLO7HE5 DRYERS � �-� <br /> . URINl.L VENTILATION FAN L.1'J_ <br /> DNINKING FOUNTNN RANGE HOOD _S�. <br /> FLOOR DRAIN AIR HANDLING UNIT- GF.M. <br /> VACUUM 0f7EAKEfiS S70VE — <br /> ROOF Di7AINS-RAINL[AOERS METAL FIREPLRCE 6 CHIMNEV _ <br /> SINK SERVICE�PAR,ETC. WOODSTOVE/FIREPLACE INSERT <br /> � SUB TO1AL � SUB tOTAL S Fj�27 <br /> PEflMIT S _ PERMIT S _ �7 <br /> TOTAL FEE S TOTAL FEE S ��/ � <br /> iHIS PORTION TO BE COMPLETED BY BUILDIfJG DEPT. PERSONNEL <br /> If10Ni5G104)CM RCARSEtOACK Si�ESEILBAL PLRNCMECRNUM�[R � PLRNC��[CNfC[ <br /> � r„J..�) � .� � � / � � ,�.� / S � 5 0 `Eo�p3 `/L REfO / � 0 � <br /> •.l. <br /> ❑5[20NE IOi�RER y�C�Ni¢ILE FEES VALURTION FEE <br /> � 'l � `� i1'"� �YES�lL1N0 <br /> tYPEOPCONSt. OCCUPRNCYGROUP NO.OfDWEILINGUNIIS _ <br /> "i�.� .7 . •,1 I BUIL�ING S�jv � �� � <br /> 5R[Of o100 � �10Af 510RI[S MA%.OLQ LOAO '1 <br /> /O�� r � PLUMBINO G � {/�i <br /> MEGIIANIC6L � 1 [�� <br /> rIRE SPRINKlERS f7E0UIRED ❑YES ❑ NO <br /> OTHER <br /> PENAUY <br /> �PPI�CAlI0N4CC.Ov CL�NSCIIECNCDBY APi'O,FORISSWINGEOY <br /> � TOTAL JJS v�� <br /> , JTv � . � <br />