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,ME„ro�.� ,-►PPLICATION Fa_.' 3,��'� <br />��^�F CONSTRUCTION � g��`� <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259•8810 TO BE COMPLETED IN INK- PLEASE PRINT <br />❑ DEMOLITION ❑ COM8INATION ❑ BUILDING �MECHANICAL ❑ PLUMBiNG <br />owNcu � v.v� o�.1�ud..P�C'. M�a�uoaEss.�6`i �, C iv�b arv JCtC'1�zm q,$a� onoHe 3>r)r <br />checK- X-� �^�qe �. 9oa IJ• Y�re�way _,ios*t <br />nnC1UtECtOROtS�GNER M�4�ODAE55 GIIV IIV pNON[ ^� V� <br />O SIGN <br />�� <br />3o3p <br />GENER�ICOHIHA�IOR / MIIL�O�RE55 CIIY IIP • O�1Q�[[Ey�� <br />JQ.,.11tiv��—Tbvi.es_ ?o.bbK�'�b �2rK�and 9b'o$� • - �,00 ���• <br />; rr.�u; �r.0 conrn.cmA r.,. � �oonas� 0 5 N• C � d j� cm ar Pr�oNe'`5A' C�• r, '�"�.r3 O� <br />��.e�_r"�C /t;c Cn ao1 IS^ _ 12e �mn,��. 98'05� 88�-33y8 <br />�IUMPIH.CONiH�LtO� MML�DOPE55 CIfY ZIP PiIONE UCENSE• <br />�1 � _ <br />f,�A550f WpNM <br />❑�EW ❑ ADDITION ';� ALTERATION ❑ REPAIq ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERi ❑ BUIIDING RELOCATION <br />vew+��oH Or wonrc �eoST ov ra� nuis rws ueoni <br />� a,5ofl.o� <br />�n scnro[ wonn <br />� � � � 1 � _ i � 1,. _ r . , � �. 9 _ _ . . —4. <br />' �`K.v�CK. <br />GROaENiY�SNOWN BEL <br />.o�— <br />�POJECT �DDRE59 ^ 1 �G,� Y Ch .u�p � <br />t� tl /\ J <br />�0� 1J• �r�ari�.�Av <br />xuMeina <br />NO. TY�E OF FIIITURE OR ITEM F <br />WIITER CLOSET �iOILET� <br />BIITNTUB <br />LAVIITOR� �WASM B�SIN� <br />SNOwER <br />KITCHEN S�NK 6 OtSP. <br />DISNW�SHER <br />UVNDRY TR�Y <br />CIOTHES WASMER <br />URINAL <br />ORINNING FOUNTAIN <br />FLOON DRAIN <br />BACKFLOW P17EVENTERS <br />ROUF ORAINS — FAINLEADERS <br />SINK (SERVICE — BAR. ETC � <br />6UlTOTAL f <br />PEIIMIT f <br />TOTl1l FEE f <br />'��UN� SE�B�CR RE�N SETB�CR SIpE 9Ei0�CK <br />USE lONE IOf�RE�. <br />VIIC�NT SITE <br />OYES ONO <br />�YnEOICON51 OCCUP�NGYGROUP NO.OFDWELLIN <br />:i2E Of Pt04 NO.Of SiORIES M1: OCG. LO�p <br />fIRE SPRINKLERS REOUIRED ❑ VES ❑ NO <br />�LC BV �PL�HSCNELNEOBY <br />I HEREBY CERTIFY THAT I HAVE REAU AND EXAM�NED THIS AP• <br />PLICATION AND KNOW THE SAME TO BE TRUEAND CORRECT. ALL <br />PHOV�SIONS OF LAWSAND ORDINANCESGOVERNING THISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE- <br />IN OR NOT. THE GNANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OiHER STATE OR IOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. / <br />$IGNRIURE OF GONiRAC10N OR �UIHOR12ED RGENi pATE�a �' � C��� <br />X � � � I l. <br />� <br />MECHANICAL <br />E NO <br />TYPE OF EOUIPMENi <br />A/C — �MNOLO UNITS — MP. <br />REFRIGEH�TION UNITS — M P. EA. <br />BOILEPS — B.T.U.MP. <br />6�5 FIPED A.C. UNITS — B.T.U. <br />FO(iLED AIR SYSTEMS -- B.T.U. M EA. <br />WALLHEATERS—B.T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORATIVE f.00LEF3 <br />CLOTHESDRYERS <br />VENTIUTION F�N <br />qANGEMOOD <br />WATER HEATER <br />WOOOSTOVE <br />MEfAL FIREPLACE 8 CNIMNEY <br />FIREPLACEINSERT <br />NEAT NMP <br />GAS PIPINO <br />E%MRUSTFAN <br />/IM TOTFL <br />VEflM1T <br />TOTAIfEE <br />PLANc;MECNNUMBER IFEE <br />BUILDING <br />PLUMBING <br />MECHANICA� <br />OTHFA _ <br />- oTATE BUILDING SURCMnP,G'� <br />STATEENERGYSURCHARGE <br />PU9LIC WC9KS <br />TOTAL <br />RGCEIPT NO. <br />VALUATION FEE <br />S <br />PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING AI.L <br />PAOPERN LINE LOCATIONS AND RELATED EASEMENTS <br />