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,�.E�,,�,� APPLICATION fdk' <br /> "�°` CONSTRUC�ION °""°" <br /> ev�rett PERM11" P+ <br /> BUILDING DEPARTMENT <br /> 259•BA10 TO BE COMPLETED IN INK - PLEASE PRINT �, Q �A� �� <br /> O DEMOLITION ❑ COMBINATION 0 BUILDING ❑ MCCHANICAL ❑ P UMBING ❑ SIGN <br /> OWNYN M�il �U[1N1':•� t �� . <br /> � r-��„ y.re ,o.v� <br />� _�.d2O� .� . n�ce�f L`L.� —/00 � i,:a[�'��✓EPr��-sJe. � � <br /> •ul:«ill tJ Uia]I apN[R Mb� �liou�ps ��� � � <br /> ' ' ' ryrr�ru� wp ♦I <br /> ti/.H i.,/f ��,f �,.��1� . i�xn�� 5f aov'�P.�jt��J�Yfr23/ � 30 9.� ia� ky� <br /> I 6kNtn�, ���N�nu.�.i� M�.i .y ���I•:. :�� nru)NI <br />' I/ � i iCl YS! • <br /> %/ <br /> MI��I C�lN1Rlftf�f� M��l �f1llRf�l i . <br /> �� ll �u�1N! I�CIN41 • <br /> �LUMP�Nii.�]4fR�lIpR M1i�LpUql�•. ��Iv (il' PUUry. <br /> {•�.tlllf • <br /> CI�StiIil WpP� <br /> ❑ NEW � ADDITION ❑ ALTERATION ❑ RFPAIR ❑ DEMOLI11pN ❑ WOODSTOVE'�RPLJNSERT C] BUILDING RELOCATION <br /> v�w�naNar wna..�:o5�ni 4�qaiMn���us�co�ue _ <br /> �� - - - �- � 3�� <br /> oeseaee wnn. <br /> ��fYl�.�'�Y�p � <br /> usro•.,uno�a�.� � �� _ <br /> I HEREBY CERTIFV THAi I HhVE RSAD AND EXAMINED iHiS AP� <br /> uc�1nesra�� �rp . nn�H�wwAtiowna�n�,:�rnuacuni•,� — PLICATIONANDKNOWTHESAMETGBETRUEANGCORfiECi P� L <br /> PROVISIONSOF LAWSANDORDINANCESGOVERN�NG7HISTVFS <br />�i � q � /- OF WOfiK Wll L BE COMPLETED WITH WHETHFR SPECIFlED HERE- <br /> io�L�einc._or �A.�E �t•��E S — IN OR NOT THE GRAN7ING OF A PEfiMIT DOES NOt PRESUME TO <br /> �yoZ7 '%Op ST 7 ! ANVCTHER,STIATEORLOCALLAWREGULATINGCONSTROUCTION <br /> �L�� OR THF PFFFORMANCF OF CONSiqUCTION. <br /> - Si,Nuii�a! n� i�i�yr ftqpp�AUl�u)pi7FUnGIN 1`n�� <br /> I VppJF6l�p[tRfi`, �� / , l / �L� <br />��� . � �.r�Nl•.i. . bu�,.yl':..i. lr �� i <br /> i�a `' <br />! OLUMBIN�3 MECHANICAL <br /> I NO. TYPE OF FI%TURE OR ITEM FEE NO. TYVE OF EOUIPMENT FEE <br /> W11TER CLOSET�TOILET� q f, –4 HNJL(i UNITS–N P <br /> I BATMTUB qFFqIGEPnT10N UNITS–H P EA <br /> I UVATORY IWASH BASINI A01LER5–A T U M P <br /> SNOWER GAS FIRED A C UNITS–B 7 U <br /> 1(ITCHEN SINN A DISP F(�FCEU AIF SYSTEMS–B T U M EA <br />� DISHWASMER W4LLHEnTEPS–BTU M <br /> UUNORY TR�Y �JNIT HEATFR$–B T U M <br />� CLOTHES WASHER EV/PORAiRECOOLERS <br /> UHINAL CLOTMES ORVERS <br />' ONINNING FOUNTAIN VENTIlA710N Fr1N <br /> FLOORORAIN PANGEMO00 <br /> BIICKFLOW PNEVENTERS W�TER HFATER <br /> ROOF DHAINS–RAINLEADERS WO00 STOVE <br /> SINN ISERVICE–BAR ETC I METAL FIREPLACE d :MIMNEV <br /> FIREPLACE INSEH7 <br /> HEAT PUMP <br /> 1 � <br /> GAS PIPING <br /> ENH�USiF�N <br />� We TOTAL f 6UB TOT�L <br /> O[RMIT ! KRMIT <br /> TOTAL f!E { TOTAL F!f <br />� �uuNr sf i0��:r�- i�t�e tif rp�i.. Smf tiEtB�[K "IANCHECI NUMBER FEE pECE1PT NO <br /> —L � � S " �8' '� 1 � 3�� <br /> s _ '-N 10�73I <br /> i�sttu�+t �����+F� ����Hrsvi FEES VALUATION FEE <br /> �nu i5-�3 .ES <br /> rvc� urrnvs+ nccu��p/c�vqnrnm Noornwe�_uNcuqrts BUI�pING S � <br />� �� � /✓/ " I � PLUM9ING <br /> 1'lf U� Hi pb Nq UI YtpPiFS MA4 OCC l O�0 <br /> 2�U S F' � N/�. MECMANICAL <br />' o.HER r <br />� {'IqE SPRINNLERS REOUIRED ❑ VES VFIO ST�TE B ILDING SURCNAPiiE � <br /> 1� <br /> STATEENERGYSUFCHARGE <br /> •��P�u.eliqN4' Pr �qPN',I;NECtl[pPv •PV: I�;NitiSil✓Ulfl� — <br /> , PUBLIC WORNS <br /> /,�(.(� /� TOTAL � a � <br /> FROFERTV OWNER$pRE RESPONSIBI.E FOR CETElIIdINING AlL <br /> PROPFRTV LINF LOCAl10N3 4ND PELATE��ASEMENTS <br />�� <br />