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Y �� APPLICATIGA FOR CQNSTRUCT'�.+bN PERMIT ��� <br />TO BE COMPLETED IN BLACK INK–PLEASE PRINT <br />CHEATING SYSTEM: ❑ GAS � ELECTRIC ❑ � <br />I �� <br />BUILDING DEPARTMENT — <br />259-8810 <br />DEMOLITION CGMBINATION <br />BUILDING <br />OYMER MA�LPDDPESS ITV <br />'t' i M.� �/,� C�. �%� 7 • C <br />TEN�NT M�IL�DORE55 CITY <br />Jflc�:pv�r ��a� rn�v--r �s � N. <br />ARCNR[CTORJCSIGN[F MARADDRf55 Ulv <br />� <br />GEN6R/dGONTRACTOA MRILAUDHESS QTY <br />����i N� 5� 6ti 17038 ��� <br />M(CMANIGALCONiRAGTOA MAILRpDR/ES$ P�V <br />PWM9INGCOFITR�SjOR MFILAUDRE55� C�iV <br />�� _ _ <br />CUSS OF WORk <br />MECNANICAL <br />]IP^n <br />��aIK <br />zlP <br />Anw� <br />PLt1MBING <br />9.4�99 <br />,iSIGN �� <br />>_gs �,� � <br />8013 <br />Z�P PIION[ SiRTE LICENSE I <br />�Zl"l�, w�9A�33 SHrJI�Est II D�G <br />i�� S4�—�'BW'3� S,,.E���EHSE. <br />¢�p n��o�e srnr�ucensc. <br />NEW �� ADDITION�--RRT X---ALTERATION C REPAIR DEMOLITION WOODSTOVE/PRPL WSEFT <br />_- _ __ _- _ __ �� ^ ^ � CONTACT i'EFSON RND PHONE NO <br />���� -,.r,, i% ._..� h/1 i P�i bi /'U,�--�ni <br />---_..._ .._....___ ___...._. __ <br />��C� __�L�%� s <br />PFOPOSED VSE O� BOIl01NG <br />CO N I�'�J; EN'G � s-ro ,P.� <br />LEGAL DESGPIP�i qN OF PROPERTY ISHOWN BELOW OR �TTACN FpUq COPIES� <br />LOi BLOGK _ OI .. ___ <br />, <br />D S 1 `Y1 �� "� ' c��a-. <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CI.OSET (tOILET) <br />BATHTUB <br />LAVATORY(WASH BASIN) <br />SH�WEF <br />KITCHEN SdJK 8 DISP <br />DISHN'ASHER <br />LAUNDRYTRAV <br />CLOTHES WhSHER <br />IIRINAL <br />DflINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PFcVE1JTER5 <br />ROOF DRAINS--RAItJLEA�ERS <br />SINK (SERVICf_-BAR. ETC.) <br />SUB TOTAL <br />PERMIT <br />FOR OFFICE USE ONLY: <br />�RONiS[�BAGK q[RNSETB\CN <br />� / ��5 %%� �.� <br />USE 20N /L��.� jpi AR A <br />!/"� N�SQ.�'[ <br />iYPE 0! CONLS. AL104 <br />SIZE OF BLOG. <br />OCCUPANCYl0�0 <br />R_AWN FOR SPRIt <br />�NTRNE BY <br />NO.OF STORIES <br />� <br />FEE <br />BUILDING RELOCATION <br />��� 8%�� <br />I HEREBY CERTIFY THAT I HAV[ FEAD AND E%AMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />F70VISIOI�S OF LAWS AND ORDINANCES GOVEPNING THIS TYPE �JF <br />WOFK WILL BE COt,APLETED WITH WHETHER SPEGFlED NEREIN OR <br />NUT. TNE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITV TO VIOLATE OF CANCEL THE PROVISIONS OF ANV <br />OTHER S7ATE OR LOCAL LAW REGULAT:r1G CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORI7_ED BV' THE <br />OWN[R OF THIS PROP[RTY TO FERFORM THE WORK FOR WHICH <br />APPLICAiION IS MADE AIvD 1 COISPLV WITH THE STATE <br />CONTFACTORS LAW 102i RCYJ AND 6 20 WAC. <br />�n <br />% <br />�r r �� .�, l�z � <br />3�—% �3 n�rz <br />�.«��-�,,,,� .,.; � <br />MECHANICAL <br />NO. TYPE OF EOUIPMENT FEE <br />A�C— ^'11rv�! G UNITS—H.P. <br />rORCCD AIR SVSTE�dS—B.7.U. M E.A. <br />UNIT HEATERS—B.TU. M <br />CLOTHES DRVERS <br />VENTILATION FAN ' <br />RANGE HOOD �— <br />W�TER HEATER ' <br />i—� <br />WOOD STOVE <br />METAL FIFiEPLACE 8 CHRdNEV <br />� <br />FIREPLACE INSERT <br />H[AT PUMP � <br />FAN � <br />61DCSEiBACK PL�NGHECyNNWA/GC��R'/ I <br />� .�l��V�T �� <br />vncnNt site FEES <br />�� BUILDING <br />O[CO>�Mb N�QOwfuiNLUNiiS <br />cxouv � / p�UMBING <br />BASEMENT MECHANICAL <br />HE i uMlunoN ADDITIONAL PLAN CHECH <br />����`� SPRINKLER <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETT PUBLIC WORHS <br />LOCALSALES <br />TAX COUEIS 3105 TOTAL <br />SUBTOTAL $ <br />PERMIT $ <br />TOTAL FEF $ <br />