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IM Ev�.prMn <br />pin or <br />everett <br />BUILDING DEPARTMENT <br />259•BB10 <br />, :PPLICATION FO��' <br />CONSTRUCTION <br />PERMIT <br />TO BE COMPLETED IN INK • PLEASE PRINT <br />everetl <br />e <br />O DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECIiANICAL [] PLUh'BING ❑ SItiN <br />awuin u.n �oon[ss cnr zu� nuorvr <br />o6.�n Foy 7GoG TyE-g 2oQ 6�/82eT7' 9b'2o3 3s�-'��y9 <br />u�cru�ir.iono��s�.rnn — M•�i.nmarss �,�, ,�,. J�._n_.�•,��,�� �zS% <br />S A M E - ----- ------ ---- <br />pl q11U1 COIIIIU(,IUII IA�II n11O1119': 1]I I /il' �9u1t11 I Illl ll':I • <br />SAnnE _ <br />MeuaH�r.•� coHnucmn � �ieiiennaEss cnr rm rnnra �¢n�s . <br />j/}ME <br />PIOMB�N . LONIfNf.lOfl <br />IA.111 aDORFS$ Gi�Y /��' Pllpq! IICUIbE � <br />CL�SiOf WOOv <br />❑ NEW ❑ /�OUITION � ALTERAIION ❑ l7EPAIA ❑ DI�.MIIUIIOH ❑ WOOD51'WClfRPlJNSfflI ❑ [IUILUWU IICLOC�IION <br />WI)I1N <br />S �t� <br />noiyc <br />� dun <br />IOJfGIe00RE55 <br />7 �}�O <br />PLUMB�NG <br />TYPE <br />�AVRTORY <br />KITLHEN SINK 8 OISP <br />DISMWASHEfi <br />LAUNDRYTRRY <br />LLOTHESWASHEF <br />URINAI <br />Y �/� N� - �v . <br />FLOOF OFAIN <br />BACKFLOW P{7EVENTE�S <br />ROOF ORAINS — AAWlEAOE <br />SiNR �SEnVICE — OnR, ETC � <br />�n�l�lISFIO�G --- (If.� <br />❑Sf IUN[ l0� <br />J , •� <br />�i ' ."_ <br />irr[or�� oc <br />� <br />Silf W PIDI: � ��^ <br />/ �vU, lrnur <br />�,c�r ,�i.Vir . <br />FIRE Sf'RINKLEPS REOUIRE <br />�PI'I�CC�iONeCf. Av PLn <br />��/\ iV' � <br />ITEM <br />SUBTOTAL f <br />PEPMIT f <br />TOTALFEE S <br />nse�o•c. xmcsnn�cr <br />AfiC� V�C�'1I.�IC <br />❑vE5 �!O <br />curnr�crcnow� uo ormvn.i <br />� � � <br />Offifqpif5 MnK OfC IO <br />z �, <br />ou res �✓No <br />a <br />r�sc��ecmm�r �rrn �o�ois�. <br />� <br />I I1ERC-BY CERTIFY TIIAT I HAVE HEAD AND E%AMINED TIIIS AP� <br />PLICATION AND KNOW THE SAME TO BE TRUE ANDCOf7RECT. �LL <br />PROVISIONS OF LAWSAND ORDINANCES GOVERNING THISTYPE <br />OF WORK WILL BE COMPLETED WITH WfiETFiERSPECIFIED HERE• <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOi PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIOPIS OF <br />ANV OTIIER STA7E OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />smr+aiuneorcoNinnr,rononnuu�onizcnnc[r+� DAIE <br />X�/ / � nS - �/ K ^7� � L�� X% <br />59 UL! ii'iF NO <br />MECHANICAI <br />FEE NO. TYPE OF EOUIPMEN7 <br />A/C — 4/HNOLG UNITS — M P <br />REFRIGE�ATIONUNITS—HP EA. <br />OOILE�S — B.1 U M P <br />GAS FIRED A C. UNITS — B.T.U. <br />FOPCEOAIRSYSTEMS—OTU. M <br />WALUIEA7ERS—OtU. M <br />' UNIT NFATERS — U T U M <br />EVAPO�ATIVE COOlERS <br />( CLOTNESORYE�75 <br />/ VENTILATION FAN <br />{7ANGE NOG� <br />� WntEf111EnTER <br />WOOD STOVE � <br />MET�I. FIIIEPIACE A G1IMNEV <br />FIREI'IACE iNSERT <br />HEAfPUMP <br />CAS PIPING <br />E%HAUST�AN <br />iqAN CMECK NUMOER <br />Ci�� <br />SUB TOTRL <br />PEPMIi f <br />TO�ALFEE 1 <br />fEE RECEIP�NO. <br />81 G ° 9� <br />OUILDING S <br />7LUMBING <br />MEG�nNICAL <br />oTriEn <br />STATE DUILDING SUf7CHMGE <br />STA1E ENEf7GY SURCHARGE <br />PUBLIC WORKS <br />TGTAL <br />PROPERTV OWNERS ��7E RESPONSI�LE FOR DETERMINMG ALL <br />PROPER7V LINE LOCATIONS AND PELATED EASEMENTS. <br />