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t��Evupro�n , �PP�.IC�I,TION fd ..� � P,Cte„ <br /> �,r�°F CONST(�UC�'ION 0 <br /> everett nERMIT <br /> BUILDING DEPARTMENT � <br /> 259-8745 TO BE COMPLETED IN INK- PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION K] BUILDING ❑ MECFIAN)CAL ❑ PLUMBING ❑ SIGN <br /> JY/NE� MMl AO��iE55 � CIiV 21P PIIONE <br /> Gverett Ilousin�; Authority 1�1th t� Popl ;ir liverett 982111 253-9222 <br /> ���unr¢eronoes�ar�en uaii�ooness cm nv v��or+[ <br /> DOAQ Architects , YS 322•1 Itietmoi•e L'verett 98201 259-3161 <br /> ]ENERALGONIR�C�OR IA�IL40ORE59 CIiV ZIP PIION[ IiC[N[.(. <br /> ��l�n i�ani���s I r,��I�Ir;;� �,,:�i -'��� c2�7.�,�1 /�c����;r S/. .:`i!��.t'r�ir.nc l-�f� ��f,lJG % �' � - 3�: �,F� <br /> 'A[L11AItiGLCONfRGCtOq �A�ILAO ness cirv � zin ruo�ir ucv�sr • <br /> �::i3•c��- J��rl�ti�,.z�i?i,EF=. <br /> oLUMBINOCONIl1AL10R IAMlp0�RE95 p1Y 21P PNONE LiCGNSL• <br /> :tR550�WORN <br /> ,Q NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLIiION ❑ WOODSTOVE/FRPL.INSER7 ❑ OUILUING RELOCA7ID�I <br /> ie��euoNovwanK�cOsrorrnar[ninisn�us�noon� � - <br /> Four Ilundred Puurteen "1'housaud and Pive Ilundred llollars (�4.F-h;500)- /ff ;' `i�r, i'' <br /> �cscnieE woaK <br /> Construction af a sin �le stor � wood Irame bldg, iucludin� all sit� , mech . ,plumbini <br /> �15F.OFBWlOV�O P l C t . <br /> 1 HER[BY CERTIFY TFIA7 I HAVE READ AND EXAMIFJED iiilS�P� <br /> �lduit Resiclenti�ll�jeli:� � � " � PLIC�TIONANDKNOWTFIESAMETOBETRUEANDCORRECT.�IL <br /> '.EO�LOESCP�Pt10NOFPOOPEfi1Y191UWNfIfLOW01iA1fAC11fOURGD19Fai PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPE <br /> OP WORK WILL BE COMPLETED 4NI fH WI IEiHER SPECIFIED HERE� <br /> �or_o�ac�ov IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRcSUME 70 <br /> GIVE AUTHORITV TO VIOLATE OR CANCEL TFIE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW qEGUL�TING CONSTRUCI ION <br /> � . OR THE PEFFORMANCE Of CONSTRUCTION. <br /> "attached�� SIGNAIUREO�GONt ��TORORAUi110R12E0AG[IJi [l�lE <br /> � � ,,;-Z �- --- ��- ,.,.-s,-- I <br /> �•�O!EWAU�BEii �PPIICANi'\f.1YAUB ESSLICC SFNO. <br /> 2735 lOth liverett NA 01���77� � <br /> PLUMBIN6 MECNANICAL <br /> — __-- __ — <br /> NO. _ TYPE OF FI%TURE ___ FEE NO. __ TYPE OF EOUIPMENT FEE <br /> _ . __.___ _'__'__ ____ _.'_'__ _ . <br /> WA7ERCLOSE7�iOILE71 AIRCOND UJIiS—HP.EA. <br /> �AIHTUB RLFRIGEqAtION UNITS—H.P.EA. <br /> LAVAfOHVIWA$H DASIN! �OILERS—II.P.EA —" _"---- .._.... <br /> SHO�'dER GAS FIRE�AC.1IN175—�ONNAGE EA. <br /> KITCHEN SINK 8 OISP FORCED AIR SVSTEMS—B.T.U. M EA <br /> �ISIIWASHER WALLIIEAIERS—B.T.U. M <br /> LAUNDAV TRAY UNIT IIEA7ER5—B.i.U. M <br /> ClO7HES WASHER EVAPORA�IVF COOLEf15 � <br /> _ WATEP HEATLR—_' � '��---- — --_ CLOiHES DFVERS-----.. .—�'— �-��--'-_ _ = I <br /> URIIJAL VENTILATION PAN <br /> DRIIlNIIlG FOUNTAIN RANGE IIOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— QF.M. <br /> VACUUM BREAKERS STOV[ <br /> ROOF�RAINS—RAINLEAUEfS METAL FIREPLACE 8 CHIMNEY <br /> $IHKISERVICE—BAR.E7C I WOO�STOVE/FIREPLACE INSERi <br /> �((''��---���SUBTOTAL SUBTOTAL S <br /> —�EfiM1T 3 ^EIiM1T — 5 — — — <br /> TOTAIFEE 5 TOTALFEE 5 <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> �nonrs'e^rnec� nenn;r�nncK smeserencre rinNc��e �uunmen rinNa�ecrcree <br /> �v LQ S ' r[e ���.. nccurir�o <br /> ,SEZa�,E �o�� �� ,r�-: 1 7`/`1 ) I J,�,_; - .j.jc..�-�__ � <br /> � �— 7"' O f �� VAPANLSIIE FEE9 VALOATION fEE _ � <br /> !�b �I V 1:�E5 0110 �Jv <br /> ( ` <br /> �rnEOfCO��Si p�filrny��GiIOUP NOOF�WCLUNGUNILS �_.1L�.[.�__. <br /> �N ��,g-Z, �+-3 7 ouaowc s o � Il'�.! 1 � . ) <br /> iilE Of pLUG L RO Of S�OIUES MR% OCC 104p — — <br /> V� 5j , I 73 PIUMBING <br /> MECNANICAL <br /> FIRE SPRIWKLERS REOUIRED LJ YES NO ---� -- <br /> OTHER <br /> PENALTY <br /> 'Ap�If.FI1011A(f tiv I�I.AllS�]IFfNEUBY APPq FORISSUANCEOY — --- <br /> �� LGy TOTAL <br /> i�• L � � , -- <br /> � � ' <br /> �.'�_����:ICl.����L._ /'(.f, � . , <br /> � ��t_ � '.d� f C i �;;�r ._ � 1 . .� ,— <br />