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�`, r� <br />�-.PPLICATION FO1. ' <br />rn. Ev�rprnn everelt <br />��TM�F CONSTRUCTION ,,y�� -_,;<�,_,� <br />everett PERMIT � e <br />�� ��E��Y� <br />BUILDING DEPARTMENT ^ � ��I _�2 � C,'?� <br />259-881C TO BE COMPLETED IN INK - PLE.,SE PRI'JT �� _ <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING C] SIGN <br />DWNtR MAILrI PESS LITV ZIP PHON[ <br />Uh: ,,:,;.. /� IV,.,�c,i:,.�, . /��^��f' "'�f�C�vC. (.c1 T��lna��s9,(�_),9n �v-�-��<-� <br />APCH�CTONUt9GNEN I 41L4UUNt5J 111Y ZIP PIIONE <br />// ✓ p <br />�`�j-'�r, . r�� /��dL�� U , Pr��IY� �ci`7� �[. ��n�^ ��,'�� i?// Jce h� kL'�ai�. '�`J^ � ' � t� � <br />GEN[RAL CONTPApiOP �AaIL a00RE55 Citt ' ZiP J o��ON[ uLENSG � <br />/ t )}l �L— <br />'CMAN�CALCONTRPLTOq MA:Ll00RE55 C11Y ZIP PIIOnt �ICENSE• <br />/`� ia� n� t'1�- <br />V�WM1B�IN�i�CUrvINFG1UH mea�uun[po bm uY Y11pNE IICLKSEa <br />� /I/)M1I � �� <br />CLA55OG WGRN <br />—� NEW ❑ ADDI710N ❑ ALTEfiATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION <br />VaWAT10N0�\YO�iA(WSiOFMaiERInLSP USLABORI <br />'� �,s�-�—�% ��Y FrZ_O —�' <br />D[SCRiBE WORN <br />/ /� <br />�� �' :'1. <br />�,. '1 \ L'ILDING <br />�CGAL DESCR PiIOH OF) PR <br />�. LOI�BLUCK.�� <br />BE�OW OR <br />PFOJECiRODRE55 <br />' � !� 1.�-� ,�1 �- �� � � �h S� <br />PLUMBING <br />OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORVIWASM BASIN� <br />SHOwER <br />KITCHEN SINK 8 OISP. <br />DISNWASHEH <br />LAUNDRVTFAV <br />CLOTMES WASHER <br />UFINAI <br />ORINKING FOUNTAIN <br />ROOF DRAINS — FAINLEADERS <br />$MK (SERVICE — BAR. ETG) <br />tHpNT$ETBACh � <br />Zo , <br />u�E LO(NE Y <br />'`J <br />rvvc pr rnnsi <br />_�— !ti� <br />s¢E or eioc <br />Z38� Si— <br />FIFE SPRINKLERS REI <br />m>vi �: uia�+cr. d�, <br />�� <br />SUBTOTAL <br />PERMI" <br />TOTALFEE <br />REAF SErBaCK <br />20' <br />LOT AREA � <br />/� ZST� � <br />OCCUPANCYGROUP <br />�'- 3 <br />NO OF SiOR1E5 <br />L <br />f <br />S <br />f <br />Z <br />f SIiE <br />❑rvo <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AF� <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWSAND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPE �IFIED HFRE- <br />IN OR NOT. THE GRANTING Of A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANV OTHER STATE OR LOCAL LAW REGUL4TING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. . <br />SIGNniUFE OF CONTR4GTGR OR AUTHOqIZEO AGENT ppTE <br />X /� V1 I! �� �L,(% <br />FEE NO. TVPE OF EOUIPME <br />— A/C—A;HNDLGUNITS—M.P. <br />�— REFRIGERATIONUNITS—HP.EA. <br />� � BOILEPS—@.T.U./M.P. <br />— GAS FIREO A.G. UNITS — B.T.U. <br />`\ — FORCED AIR SY£TEMS — B.T.U. <br />— WALL HEATERS — A.TJJ. <br />JNIT MEATERS — B.T'.U. <br />(� j '— EVAPOPATIVE COOLERS <br />CLOTHESDHVERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STGVE <br />METAL F19EPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />E%HAUSTFAN <br />Z <br />M4% OCC LOAD <br />PR (OB 55UANCE BY <br />/� <br />ii�• <br />PLAN C CK NUMBEfl <br />���� ��� <br />M EA. <br />M <br />M <br />suuro-a: n .� <br />PERMIT 3 <br />TOTALFEE f <br />PEE . I �j` AECEIPT NO. <br />.- :V- ��_�� � � <br />��? � � l I <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER y�1I� ��� �� <br />STATE BUI� DING SURCH.49G <br />STATEENERGYSURCHARGE <br />PUBLIG WORKS ' <br />TOTAL <br />t"' <br />PROPF.RTY OWNF.RS ARE RESPONSIBLE FOR DETERMININCa ALL <br />PROPERTV LINE LOCATIONS AND RELATED EASEMENTS. <br />