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� ,�.E,.,,,„� '�;:.PPLICATION FO ,. ���,�„ <br /> °�TM°F CONSTRUCTION <br /> everett PERMIT � <br /> , BUILDING DEPARTMENT <br /> 259-8745 TO BE COMPLETED,IN INK- PLEASE PRINT <br /> O DEMOLITION ❑ COMBINATION O BUILDING ',�MECHANICAL ❑ PLUMBINQ ❑SIGN <br /> OWlIER MRILAOORE55 Clry 21P PHONE <br /> l r --p � !� <br /> � �4.`i2 �L�s9A.�.GtC� Y-O�sl/ /1t�2" �..4� `/�0 �� <br /> . �RCNi ECI0ROE910NEP M�iLA00PE99 CItY 21P PHONE <br /> __4 <br /> OENER LCONTR�GtOR M�IL��ORE55 CIiV 2iP PMONE LIGENSE� <br /> �� �Q- c�,. _ a o l�.t G��' � Cc� 5 tTa � e <br /> ME H�NI �LGONIR�GIOq MAIL�OORE55 CIfY =IP VNONE LILENSE• <br /> VLUMBiNOCONIp�CiON MML�pDAE59 CiiY ilP PUONE LICENSE• <br /> � � <br /> CLA540F WORN <br /> � NEW ❑ AODITION ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/Fi7Fl.INSERT ❑ BUILDING RELOCATION <br /> �, V�LU�iIONOFWORN�CO5iOf1Aa�[I1IRLSPWSLABORI <br /> ' .�.� �C.Lt_e . *Q.QS� <br /> oescnieE wonK <br /> y <br /> usE oF Buil Nu , <br /> I HEREBY CERTIFY THAT I HAVE REAO AND EXAMINED THIS AP- <br /> PLICATIONAND KNOW THE SAME TO BETRUEANDCORRECT.ALL <br /> LEO�LDESCNIPiIONOFPfiOPER1Y�3MOWNBEI.OWON�TI�CHFOURCOPIES� pROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE- <br /> ' LOI.�BLOCIL_OF �� INORNOT.THEGRANTINGOFAPERMITDOESNOTPRESUMETO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OK <br /> ANY OTHER S7ATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> UR THE PEFFqRMANCE OF CONSTRUCTION. I � <br /> SI�NATUREOFCONTRACTORORAUiHORIZEDRGENT 04TE S S-8> <br /> X � <br /> � VROJECT�ODRE35 APP4CRNT9CII BUSINESSLI�ENSENO. <br /> D — ! b Z 1L Q(LPLw — <br /> I� PLUMBINO MECHANICAL <br /> I NO. TYPE OF FIXTURE FEE NO. TYPE OF EOUIPMENT FEE <br />� WATERCLGSET�TOILEn AIRCOND.UNITS-H.P.EA. <br /> BATHTUB REFRIGERFTION UNITS-H.P.EA. <br /> I. LAVIITORY�WASH BASIN� BOILERS-H.P.EA. <br /> i SHOWEH pA5 FiRED AC.UNITS-TONNA�E EA <br /> I KITCHEN SINK 8 DISP. FOflCED AIq SVSiEMS-B.T.U. M EA. <br />�� OISHWASHER WALLHEATEqS-B.T.U. M <br /> IAUNDRY TRAV UPIIT HEFT[HS-B.T.U. M OS.00/1 <br /> CLOTHES WASHER EVAPORATIVEGOOLERS <br />�I ' WATER HEATER CLOiHES DRYERS <br />�� URINAL VEN�ILATION FAN <br />� DRINKING FOUNTAIN RANGE HOOD <br />' — <br /> FLOOR DRAIN AIR HAN�LING UNIT- C.F.M. <br /> i <br /> VFCUUM BREANERS STOVE <br />'' ROOF DRAINS-RAINLEADERS METAI FIREPLACE d CHIMNEV <br /> I <br /> SINK�SERVICE-BAR,ETC.) WOODSTOVE/FIREPLACEINSERT <br />'� <br /> v <br />�r� SU9TOTAL SUBTOTAL = <br /> PERMIT S - PERMIT y <br /> ' _ TOTALFEE S TOTALFEE S <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> fFONiSEIORCN REPfISEIpPCK SIOESEtBACK PLANLHECRNpNBER PLANCHECNIC° <br /> LEE RECEIPt b0. <br /> USE IONE �Of Al1EA yq�pNT SIIE <br /> OYES ONO FEES V�LUIITION FEE <br /> TYPEOiCOHFT. OCCUPt.NG1 SROt1P NOOFDWELLIN�UNIfS <br /> B111L01NG S <br /> 512E OF OL�O. Np pF SIORIES MA%OCG LOAp <br /> PLUMBING <br /> MECII�NICAI. <br /> FIFE SPRINKLERS REOUIRED ❑YES ❑NO <br /> OTHER <br /> PENAL7V <br /> RPPLIC>IION RCC BY PLAIIS CIIECKED BY APPR.FOR ISSURNCE BY � <br /> TOTAL <br />