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the�t�a;� <br />cm oF <br />everet�t <br />259-8745 <br />� �')NSTRUCTIO[V <br />PERIVIIT <br />PERMITNU. � 7224 <br />❑ D@MOLITION ❑ COMBINATION G BUILDING (.� MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNEN MRl n9�RE55 Crt� ZU PnONE <br />Rapp, Richard L. G803 Berkshire Dr. E�erett 98203 353-6779 _ <br />•RCN�TEflUB�CS�GNE11 MMI���riESS C�Tv Z�P PNONt <br />OENf.R�ICCWTR�CTOR RV.iL�OLPE55 CrtV !�Y RIONE LICENSE� <br />Same <br />MECN�N:C�I CONTR�C�OR • MAII ADURES`v CITY 21P PHfN1E LICENS� • <br />VLUMOiNO CONTR�CTOH M1h �pDRE55 CITv 2�P PHONE I:CENSE • <br />Cl A$S OF WOPN <br />O NEW ❑ ADDITION ❑ ALTERATIUN ❑ REPAIR ❑ DEMOLITION ❑ BUII�INO HELOCATION <br />W WATION OF N'ONN <br />{ <br />DESCRIBE WORM � <br />1(18td11 WOOd BtOV� _ _ <br />❑ ELECTR�CITY ❑ 6AS ❑ WOODSTOYE ❑ OTHFR <br />LOT _ PLOCI( _ <br />PLIiMBINO <br />NO. TYPE OF FIIITUNE O <br />WATE�i CLOSET �TOILET� <br />BATNTU9 <br />LAVATORV�WASH BASINI <br />SHOWEH <br />NITCMEN 3�NN 6 �ISP <br />DISNWASHEH <br />LAUNDRVTRAY <br />CLOTNES WASHEP <br />URINAI <br />DRINKING FCUNTAIN <br />FLOOF ORAIN <br />BACKFLOW PREVENTCRS <br />FOOF DN41N5 — RAINLEADERS <br />SINK �SERVILE — BAR, ETC i <br />BUBTOTAL <br />PEPMIT <br />TOTAL FEE <br />occur�Ncr <br />NO Of <br />ACf, flv � i'UNSCHECI(EAOV <br />V�CANi S�iE <br />❑vE5 L)NO <br />I HEREBV CERTIFY THAT I HAVE READ AND EXAMINEC THIS <br />APPLICATION AND KNOW THE SAME TO BE TNUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS 1 VPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEFEIN UR NOT. THE GRANTING OF A <br />PERMI7 DOES NOT PRESUME TO CIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUOTION OR <br />THE PERfORMANCE OF CONSTRUCTION. <br />SIGNRjp(IE Of FONTR�CTOR. �UiHO,(iqCO AG�NT. Oif OWNER � � Or1TE � <br />X <br />MtCHANICAL <br />FFE NO. TYPEOFEOUIPMENT <br />A-C — A�HNDLG UNITS — M P <br />REFRIGERATION UNITS -- N P EA <br />BOILEHS — B i U/H P <br />GASFIREDAC UNITS—BTU <br />FORCED AIR SYSTEMS — B T U M EA <br />WALLNEATERS—BTU M <br />UNITH2AlERS—BTU M <br />EVAPOiiATIVE COOLERS <br />CLOTIIES DRYERS <br />VENTILATION f AN <br />RANGEHOD� <br />YIATLR HEnTER <br />1 WOOOSTOVE <br />METAL FIREPLACE 8 CHIMNEV <br />FiREPLACCINSENT ��QbIBG � <br />HEA�I'L1MP � <br />GAS PIPING b�IT22�V <br />EXNAUSTFAN IIECH <br />Unas <br />issunr�ce nv <br />BUB T07�L <br />PERMIT <br />TOTALFEE <br />CNECNNUMBER FEE <br />BUiLDING <br />PLUMBING <br />MECHANICAL <br />INVESTIGATION FEE <br />STn7E OUILDING SURCHANG <br />SfA7EENERGYSURCHARGE <br />�RIVEWAV f'ERMIT <br />S <br />Sec 304�c� <br />NO <br />U <br />9-�? • <br />T.M. <br />TOTAL <br />_ — PENMIfVALID�TION <br />WHEN PROPEFLY VAUDATED p�! THIS SPACE� TMI515 YOUR 1'EFMIT <br />d� <br />cv <br />N <br />� <br />� <br />