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HPPLICATION FOR' <br />'".`".'°,"" CONSTRUCTION <br />cm or <br />everett PE�MIT <br />BUILDING DEPARTMENT <br />259•8810 TO BE COMPLETED IN INK- PLEASE PRINT <br />❑ DEMOLITION O COMBINATION ❑ BUILDING ❑ MECHANICAL <br />CONiRnG10R <br />M�IL <br />M�il <br />b1Y <br />dPLUMBING <br />ever�n <br />r� <br />O SIGN <br />LV PHON[ <br />DI' �4iOHF LiCENSE • <br />�uONE liCLuSC • <br />. �.._.�.__ __..... _._ <br />FICG!/,Fi�Td"�S�S1717'h /�Gs�J'I7l�l� ��, / -N� 9� n� a 9�'i!s �G ) -n3�r9 <br />Cl�sS or woAn <br />� ��EW �ADDITION ❑ ALTEfiATION ❑ FEPAIF ❑ DEMOLI110N ❑ WOOOSiOVE/FPPL.INSERT ❑ BUIL�ING RELOCATION <br />WIu�LONofWOnn�CO5lorMnlcn�eLsrlu5L�0Un� - <br />�7�'A7fT . /17 <br />usCe o� ewioiNnc ' <br />Jr�i /� � <br />LCO�LDE RIPIIONOFPNOPEPI <br />LOt�BLOCIL�Of_ <br />�iv�.s�o�v � , <br />i�ac,. � <br />Vf10JECi�DDRESS <br />7128 l'� <br />PLUM9ING <br />L�VATORY�WnSNB�: <br />SHOWER <br />1(ITCHEN SINN 8 OISP. <br />OISHW�SHER <br />OHINMING FOUNTA�N <br />FLOOR DRAIN <br />BACKFLOW PPEVENTEFS <br />ROOF DR�INS — RAINLEAUEFS <br />SINN �SERVICE — BAR. EiC � <br />SUBTOTAL <br />PERMIT <br />TOTAL FFE <br />»7 ,4�v.� O0� <br />toviEs <br />w <br />SE1B�Gn <br />USE iONE I LOI�RG l y�(;�NI SIIL <br />❑YES ONO <br />FIPE SPPINHI.ERS REOUIPEU ❑ YES ❑ NO <br />PL�NSGHECMF,D�Y �ernn ron <br />1 HEREBY C�RTIFY THAT I HAVE READ AND EXAMINED Tfi15 AP• <br />PLICATION AND KNOW THE SAME TO Bc TRUE ANDCORRECT. ALl <br />PROVISIONSOF LAWSANDORDiNANCESGOVERNINGTHISTYPE <br />OF WORK WILL BECOMPLETED WITH WHcTNERSPECIFIED HERE• <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE .4UTHO���TY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANV OTHER STATE OR I.00AL t AW REGULATING CONSTRUCTION <br />OR THE PEHFORMANCE UF CONSTRU TION. <br />swr+ntun� o corv aon an nunwnizeo rvr nnre <br />X /��. � �_.. <br />� <br />MECHANICAI <br />TYPE OF EOUIPMENT FEE <br />A/C — AiHNOIC UNITS — M F <br />REFRIGERATION UNIT$ — H P. EA <br />BOILER$ — 9.T.0 /H P <br />GAS FIflED AA. UNITS — BS.U. <br />FORCED AIR SYSTEMS — B T.U. � EA. <br />WAIIN':ATERS—B.i.U. M <br />UNIT MEATEHS — 0 TL M <br />EVAPOPATIVE COOI[RS <br />CLOTHESORYERS <br />VENTILATION FAN <br />RANGEMOOD <br />WA7ER MEnTER <br />WOODSTOVE <br />METAL PIREPLACE d CHIMNEY <br />FMEPLACEINSERT <br />HEAi PUMP <br />GA$ PIPINC � <br />EXNAUSTFAN <br />SUBTOTAL <br />PEPMIT <br />�— TOTALfEE 1� _ <br />PIAN CMECN NUM9ER I FEE � NECEIPT NO. <br />BUIl01NG S <br />PLUMBING <br />MECHANICAL —� <br />OTMER <br />STATE AUILDING SUHCMARGE <br />S�ATEENERGYSURCMARGE <br />PUBLIC WORNS <br />TOTAL � <br />PROPERTY OW NERS ARE RESPONSIBLE FOR DETERMINING ALL <br />PROPERTV LINE LOCATIONSAPID RELA7ED EASEMENTS. <br />