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� <br />� <br />m.e�.ro�«n <br />CITY OF <br />everetx <br />BUILDING DEPARTMENT <br />, 259•8810 <br />�:� ,. „ <br />�PPLICAT�ON FO�i� <br />CONSTRUCi'ION <br />PERM9i <br />TO BE COMPLETED IN INK • PLEASE PRlNT <br />everch i <br />e <br />❑ DEh+10LITION O COMBINATION ❑ BUILDIN3 ❑ MECHANICAL O PLUMBING ❑ SIGN <br />OWNER M411A0D�iE55 CIIY ZiV PH�NE <br />/�e�.N.r� g S•n��I`�i /'d BoX � 9�_ ��rST�eas 9&�s8 G�.3 aoao <br />�RCHI�CCtJROk$IONLB MNLnpD11fS5 Glv ;iP f91pry[ <br />GENEPPLCONtqAGIO❑ 1.1>II n0U1�L:5 Ci�v Jir �9�ON! IICCNS[ • <br />' ScL�'7� /�jELGM /gOP�I <br />. MECMFNiC4L CONTPPCiOfl �AAIL AIIORC.55 CrtY 21P PIIOqE IICENS[ • <br />; <br />PLUMPINOCONiBACIUH i��All �UD��E55 Cilv ;P� Il�Oi1F LICENSE • <br />CLP55 F WOBH <br />�[W ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DGtdOLIIION ❑ NJOODSTOVF/FiiPL.INSERT ❑ BUI�DING RELOCA710N <br />vnwArioN or wone ieosr ov rnaicn�Ais r�us �nnnra <br />Hh��Soa � <br />oEscaint wonK p ,/� `/ <br />UlOdl .S�iiio�P �QryJi�V fOf./)Ili�f/�0 ,�/IPi�r� �'��/'iUl �ZN ��. <br />L[GAL <br />�or <br />FFOJEGT <br />PLUMBING <br />onarrna�ruun <br />NO. TYPE OF FI%TURE OR ITEM <br />WATER CLOSET �TOILET� <br />�J BATIiTU6 <br />�_ LAVATORY �Y/ASH BASIN) <br />SMOWER <br />KITCMEN $INK 8 DISP. <br />UISHWASHER <br />LAUNDRYTRAV <br />CLOTMESWASHER <br />URINAI <br />�RINHING FOUNTFIN <br />FLOOR OFAIN <br />BACNFLOW PREVENTERS <br />ROOF OFAINS — RAINLEAOERS <br />SINK ISERVICE — BAR. ETC.1 <br />LPONi Sf.lOACr( <br />z�, <br />USELONE <br />/�- / <br />nve o� r� <br />1� r�J� <br />size ov oi4c <br />SUBTOTAL <br />PERMIT <br />TOTAL FEE <br />�'%S� `� <br />oCcuPANcrGRouP <br />�'-3 <br />�i0 Oi' StOf11E5 <br />I a�]; Nv I PI I.NSGrIf:Cnlu 1 <br />l,vi,v� /.�v <br />�ree- <br />I HERGBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW TH E SAME TO BE TRU E AND CORRECT. ALL <br />PROVISIONSOF LAWSANDOFDINANCFSGOVERNIIJGTHISTYPE <br />OF WORK WILL BF. CCMPLETED WITH WHETHER SPECIFIED HERE- <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTIIORITY TO VIOLA7E OR CANCEL THE PROVISIONS OF <br />AN� OTHEF STATC- CR LOCAL LAW REGULATING CONSTRUCTION <br />OA THE PERFORMANCE OF CONSTRUCTION. . <br />sicrinTuaeorcurnnncra+onnuuieniz�onceNr o,ue <br />SE � X <br />nPPUGnI: r� Cl�v 8U!:iqCSti l�l! NiL NO <br />MECHANICAL <br />FEE NO. TYPE OF EOUIPAIENT <br />� U(� NC—A/HN�LU'UNITS—HP. <br />�J �� �EFRIGERATICN UNITS — H P. EA. _ <br />� BOILLRS—�SU/HP <br />GAS FIqED A C. UNI rS — O.i l/. <br />j (� fORCED �IR SVSTEMS — B T U. 61 EA. <br />WALL HE�TEqS — B.T.U. M <br />UNITHE�TERS-9S.0 M <br />� EVAPORATIVECOOLEFlS <br />CLOTH[SORYERS <br />VENTIIATION FAN <br />l7ANGE HOOO <br />� ivATEFi HEATER <br />w00[15TOVE <br />MFTAL FIR[PLACE 8 CHIh1NEV <br />FIREPLACL INSEfiT <br />NEAT PUMP <br />GAS AIPING <br />EXHAUSTFAN <br />r+o or oweumf. UNIfS <br />� <br />!An% OCC LOPp <br />N,9- <br />VI.AIV CHECK NUMpER <br />� 7 / I 8 b(aG <br />BUILDING <br />PLUb101NG <br />M[CHANICAL <br />OTHER <br />S7ALE 6UILDwG <br />SUBT�TAL <br />PEHMIT <br />TOTAIFEE <br />FEE <br />Z ` V�— <br />VALUATIOi�' <br />SiAT[ENERGVSUHCHARGE <br />nrre i ai i,:unuC[ ur � <br />PUULIC WOfli: i <br />TOTAL <br />�5 <br />FEE <br />FtEGEIPT NO. <br />�03 <br />PROPER�Y OWNf'RS ARE FESPONSIBLE FOR DFTERMINING ALL <br />PHOPERTY' LINE LOCATIONS AND F;ELAiED EASEMENTS. <br />