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� _ <br /> APPLICA�N FOR CONSTRUG�'IQ�1 <br /> PERNiI'T <br /> tM Ewrproen <br /> CITV OF cverett <br /> everett e <br /> BUILDING DEPARTMENT <br /> 259•98�o TO BE COMPLETED IN INK— PLEASE PRINT <br /> � n MeIL/.DDREBS pTY IIP PHONE <br /> GL�/IIA�-iDS t�O�.sS ��RtCVnao gZ�-�� <br /> TE T MML�DDREB CiTY IiP PnONE <br /> •M.NRECTOROE9KiNER MMLW�REHB CITY SIP PMOHE <br /> OEMER�LCONTRIiCfOR MI.IlA0DRE8S GRY 11V PMONE IICFN4E• , . <br /> _ '.! 1 <br /> ME 1 NICI1fANTRGCTOR MMLAOORES9 GRY 21G PNONG �ICENSE� <br /> lzon� W 41� _26o�=f�.{ �'S cJ CY.c�nl�p 3� �4s 3� flc�e���i�ny <br /> R lIMOCONTR�C}ON MMLApORE55 CITY 21P � PMONE LICEM6E• <br /> CUN i NORK . . <br /> NEW ❑ ACDITIpN ❑ Al(EMTION ❑ REPAIH ❑ DEMOLRION U WOODSTOVE/FRPL INSEFT ❑ BUILDINO RFLOCATION > >" � ' <br /> M�M IMPROVEMENI OR IMERqN PEMOOFL ONLY COr�NT�CT PEBSON�ND PMONE NO '�j <br /> CONTR�CT PIIICE OF WDIIK� , .1 \��'/V ��/�I/ �'�.,,j !J O <br /> CE lEWORK� 090u�REFOOTMEIM/OLVEO �y <br /> �'v�. <br /> — Ep EO—EMIILDiNO � IHEREBYCEFTIFVTHATIliAVEREADIINDE%RMINEDTHISAPPLIC�TIONAND <br /> � KNOW THE SAME TO BE TRUE ANO CORRECT.ALL PROVI510N90F LAWB ANO <br /> i ni ION Of PROPEiiTI'AHOWN BELOW OAAT�CM FUURGOlqE.7i ORDIN�NCES OOVERNING THIS TYPE OF WpRK WILL BE COMRE7E0 W17N <br /> WMETMER SPECIFlED HEFEIN Oii NOT.THC GFiANTIN�OFA PERMR DOES NOT <br /> PRESUME TO GIVE AUTHORITV TO VIOLPTE OR CANCEL THE PROVI510N9 OF <br /> Lm a�ocK or �— ANVOTHERSTATEORLOCA�LAWREGUUTINOCANSTRUCTiONMTHEPEiF� <br /> PORMANCE OF CANSTFUCTION.THAT 1 hM AUTHORIZEU 8Y THE OWNER OF <br /> THIS F'ROP[RTY TO PERFORM THE WONN FOR WHICM APPIIC�TION IS MADE <br /> — AND I COM LY WITH THE STATE C'JNTOACTORB L1W 1827 pCW AND <br /> 296.2 <br /> &ON CO 0110R�UfNOR12E0�0EM UIRE � /�� . <br /> �IULO CoC..(;��� _ X <br /> PwfUECT�DDNE35 �pXl 'ITYB INE96LiGEN9EN0�NOBU81NE84N�ME <br /> �LUMBINO MECMANICAL �'D a �� � <br /> NO. TTE OF fIXTU1IE OII ITEM FEE NO. TYPE OF EOUI ENT FEE <br /> WATER CLOSET(TOILEn A/C—NHNbLG UNITS—N.P. <br /> BATHTUB FrypCED AIR SVSTEMS—B.T.U. M EA <br />� LAV�TOHYryVASHBASIN) UNRHEATcqS—DI.U. M <br /> SHOWER CLOTIIES DRYERS <br />� KITCf1EN SINK 6 DISP. VENTiLATION FAN <br /> DISNN'ASHER RhNGE HOOD <br /> LAUNDAYTRAY WFTER HEATEH <br /> CLOTHES WASHER WOOD STOVE <br /> 'URINAL METALFIR[PLACE6CNIMNEY ' <br /> URINKiNO FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRRIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPIN6 <br /> ROOF DRAINS—RAINLEADERS E%HAUST FAN <br /> SINK(SERYICE—BAR,ETC.) <br /> uUBTOTAL 5 SUBTOTAL S <br /> PERMIT S P'cRM17 S <br /> TOTAL FEE S TI)TAL FEE S <br />' iNONT6Et9hGK REFq6ETB�CN SIOE6EtP�GN PI.I�MCNECRHIIMBEq fEE IIECEIRMO. <br /> uBEzoHE im,w� v�uniertE FEE8 VALUATION FEE <br /> O YE6 O NO <br /> TYPEOiGON6T p��PANCY0N0UP NOOfOWELLIN0UNR6 BUILDINO <br /> MLOW�BIFJI�CfUN. — — <br /> PLUMBINQ <br /> RIZEOiBlDO. NOOF6TOFIE9 BSMT. OCGLWID <br /> u r MECNANICAL <br /> on — <br /> NE10MiLIM�iA1DN OTHER <br /> FIpE BPRINRLENS NEOUIPEO o ree o No STATE BVILDING SURCHAFOE <br /> FTATE ENEROV SURCMRRGE <br /> �PPLICATONACCBY PLNIg�PP1i.BY <br /> � �� PUBLIC WORKS <br /> TOTAL i <br />