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'�iPPLICATION FO� <br /> rn�Ew�pmn everetl <br /> "«�F CONSTRUCTION e <br /> everett PERMIT <br /> TO BE CUMPLETED IN BLACK INK-PLEASE PRINT <br /> BUILDINO DEPT. <br /> 259•8745 ❑ COMBINATION ❑ BUILDINO ❑ MECHANICAL ❑ PLUMBINO ❑ SIaN <br /> OWNN M�R�OORE68 CitY Z�P P��ONE <br /> C�-,1��.,. �r,•.r;u� <<����u��i��a 3J1J ���'1� C✓trr.�l ?°7.n1 d?9 211�� <br /> p1C111tFf.I00 E�IONER M�IL UNE!! GII� !IP PNONE <br /> OFNEPILCON�B�C�OR M�IL�DOBEe� G�IY lIP PNONE LICEN9C• <br /> C�Vv11, � <br /> MF.CN�NIC�ICONIR�CtOq M�IL�OOREO! Clrv IiP PrONE IiCEW[• <br /> tvi•�vi�� J�r.�c Sl�re � h�t�al rnr. PD �o�C ISOC E�TrC� 9d.201 �S� �J1�4� EVCR-6S'Slv�pi! <br /> PLUMEMlOCUMIN�CIOfI M�Il�00NE8� Clrv 2iP P110NE IICENlf� <br /> 61�99Of WONK <br /> � NEW ❑ ADOITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLI710N ❑ WOODSiOVE/FRP'.INSERT ❑ BUILOINO RFLOCATION <br /> M111�IlUNUf WU111t�C09�U�Mn11111�1BPLVSUlOBI <br /> '� ;c reo <br /> otscnip[ �nK <br /> i � <br /> ��,�.�I., II��I,�,. �,_ s GA� «f,� ll,�, r _ <br /> usc o�ewi.niHn <br /> I HEREBV GERTIFY THAT I HAVE RERD AND EXAMIN,cD THIS AP� <br /> PLICAiIONAND NNOW TFIE SAME 100F TRUE AND CORRECT.ALL <br /> lF(1qbE9CN0IlONOiPPOPENIY�9MOWN8ELOWOf1�R�CNFOURCOFIEl1 pROVISIONSOFLAWSANDORDINANCES00VERNIN6THISTVPE <br /> OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIEO FIERE� <br /> ior_eiocK_or IN OR NOi.THE ORANTINO OF A PERMIT DOES NOT PRESUME TO <br /> OIVE AUTHORITY TO VIOLAiE OR CANCEI THE PROVISIONS OF' <br /> ANYOTHER STA7E OR LOCAI lAW REOULAiINO CONSTRUCTION <br /> � OR TH[ PEHFORMANCE OF CONSTRUCTION. <br /> BION�TURE OF CONTR�CIOR OR AUi110RlIE��6ENt pAIE <br /> X � :3 -�l-ks <br /> o �� u«� � <br /> CpOJECUOUPESS �vruuq CIIVBUSME39LiCEN5EN0 <br /> I lii: � �r�: "' r') ,r� r✓��r : <br /> PLUMBINO MECNANICAL <br /> NO. TYPE Of FIMiUN[ FE! NO. iYPE OF lOUIPMENT iEE _ <br /> WAIER CLOSET(TOILEq �IR COND. UNITS—II.P.EA. <br /> B�IMTUB PEFRIOERATION UN11S—HP.E�. <br /> LAVAfOl7Y�WA9N O�SIN� BOILERS—MP.EA. � <br /> SHOWER � 0�9 FlHED AC.UNIT9—TONN�OE EA���� <br /> ,�µ�., �o_� <br /> KIICIIEN SINN!DISP _ FORCED AIR SYSTEMS—B1D. RI EA _ <br /> DISHW�SHEP WALLIIEAiEflS—BT.U_M _ <br /> LAUNDRY IRAY UNIT HEAT[P9=B T.U. M <br /> CLOIIIES WA9HEB EWPORATIbF.COOLERS _ <br /> W�fE�HEAfER CLOTHE9 DRjERS <br /> Uf11NAl VENTILIITION!�V _ <br /> ORINNINO FOUNIAIN RRNOE NOOL ._ <br /> �I n�ilt f��NN ��R N�NOLINA IINIT— C i M <br /> VA(;UUMt1Nk�NLllti SIUVE __ _' ' <br /> ROOi DRAINS—RAINLEAUEfi9 METAL FIqEPUCE!CHIMNEY __ <br /> SINMISERVICE—Brlfl,ETC. WOO�STOVE/FIREPLACE IN9ERT _ <br /> 8UB TOTIIL !UB TOU� • _30. v <br /> _-- --PERMIt � PENMIt { __�O_. O�_ <br /> TOTALiEE f TOTALFEE t 9 0 O <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> TOHISFIp�Ln ��I:���SUB�GM SIpEBE1B�CN PL�NC�IECaNUMBER pUNf.ntcerEE <br /> fEE OFC(inl bJ <br /> USt lUNE LUI�NE• y�C�NI�pE <br /> ree� VIILWTION ff� <br /> OYE! ONO — -- <br /> �vPEOlf.OMS! OLCU��NCv6ROVP NOOfOWEILINOUHIi� <br /> BU�l�INO 3 <br /> SNF Of BLUO NO U�SIOf1iE9 M�IL OGC LO/�0 - -- <br /> PLUMB�NO <br /> MECN�NIG�I O OQ <br /> fIRE SPRINI(LERS REOUIf7ED ❑YE3 ❑NO <br /> OTHER <br /> PEN�LTV <br /> �PPIILAIiON�GCB� �9���SUIECM(09v I�PPRfORi!lU�NGEBY � ' <br /> I TOT�L <br /> � <br />