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fM Er�ryrMn <br />an w <br />everett <br />BUILDING DEPARTMENT <br />259-88 t 0 <br />❑ DEMULITION <br />OWXEA <br />�� � <br />�..�PLICATION FOR-�� <br />CONSTRUCTION <br />PERMIT <br />TO BE COMPLEYED IN INK • PLEASE PRINT <br />❑ COMBINATION Ip <br />M�IL �DOf1E55 <br />�'�r�,�o 9��o-aov��r�,;, <br />MaL �40RE55 <br />BUILDING ❑ MECHANICAL <br />� C�TY bV <br />�i�,�yNrt/!✓�OD GtJA. �PO.3G <br />tln � iiP <br />`i�ic�--',i/: a �-'� , a G �fG <br />CI1Y iIP <br />❑ PLUMBING <br />PNOYE <br />� 75-' <br />VHOHC <br />:n,l vs%s;'. �t <br />❑ SIGN <br />'hAv� ���»r3 YY1 fi�l�a.�Rr ('a.Gr� S�a;r�� <br />MECN�NICtLGON1HICTOq ��LL� ORG55 GIfY $IP PNOHE LIGEN�C• <br />u <br />uGENSE• <br />f��550f WOHM ' <br />L] NEW ❑ PODIiION .RI ALtERAT10N ❑ PEPAIR ❑ DEMOLIiION .❑ WOODSTOVE/FRPL�NSERT ❑ BUILDING RELOCATION <br />v� WAIIOH OF/WJOA�N ��OSi OF M�LENI�LS PLOS UBORI <br />/O� i �/� • <br />OESGRiBE WOI� <br />'✓/� N � I <br />n�uMsiNc <br />FOUN GOPIE51 <br />KITCMEN SINK i DISP. <br />DISMW�SMER <br />UUNDRY TRAY <br />CLO7ME5 wASMER <br />URIN�L <br />DRINKING FOUNTAIN <br />FLOORDRAM� <br />BACNFLOW PREVENTERS <br />NOOF �RAINS — RAINLEADERS <br />SINK ISERVICE — B�R E7C.1 <br />�uONT5El0�CN <br />� <br />U5E ZON� � <br />.(�� <br />�YFE OF CONSi <br />� N <br />c�non�cG.er <br />� <br />PERMIT <br />TOTALFEE <br />RSETBAGN <br />� <br />�NCYGROUP INO. <br />�-Z <br />r <br />� <br />� <br />Zc <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATIONANO K�OW THESAME TOBETRUEANDCORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTFUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. . <br />516N�7URE OF CONTR�C�UUR Of�IUTHORREO �GENT UAiE <br />MECN: NICAL <br />A/C — AMNDLQ UNITS — M.P. <br />NEFRIGERATION UNtTS — N P. EA. <br />BOILEFS — B.T.U.ni.P. <br />FORCED AR� SYSTEMS — <br />W�LL NEAiERS — B.T.U. <br />UNIT HfJ1TEN5 — B.T.U. <br />EVAPORATIVE COOlEflS <br />CLOTHESDRYERS <br />VENTIUTION FAN <br />RANGEHOOD <br />WATER HEATEC <br />wOODSTOVF. <br />METAL FIR:.PLACE 8 CHIi <br />FIRE7UCE INSERT <br />HEAT PUMP <br />GI1S nIPINd <br />Ex1uU5T FAN <br />NUM9ER <br />!UlTOTAL <br />M <br />M <br />M <br />FEE � �� I RECEIPT NO <br />b � q� <br />BU�LO�NG S <br />PIUMBING <br />MECHANICAL <br />OTHER <br />ST�TE BUILDINQ SURCM�NGE <br />STATEENEPGYSURCHARGE <br />i'UBLIC WORK3 <br />TOTAL <br />PROPER7V OWNERS ARE R[SPONSIBLE FOR DETERMININO ALL <br />PROPERTY LINE LOCATIONS AND REUTED EASEMENTS. <br />