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.APPLICATION FO..' <br />FM EF.grfBn CONSTRUCTION e <br />CITY OF <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259-8745 TO BE COMPLETED IN INK • PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OyY MAIL ADDRE59 CITY 21P PHONE <br />'ba � 35�/ �(FCAI <br />atJC'�? E�lr'r <br />..............., .,..tee uuI mDRE55 CITY ZIP PHONE <br />GENERA) <br />����111fzIC'S <br />CONTRACTOR <br />MAIL ADDRESS <br />{���PIJ ,S�I <br />�t CITY ZIP <br />YYrl�a'N�/�11P LC)Cr"'lT <br />/ PHONE <br />�J/1 <br />LICENSE• <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE <br />LICENSE• <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE <br />LICENSE• <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION <br />VALUATION OF WORK [COSTI7F MATERIALS PLUS LABOR) <br />s5c.1 <br />DESCRIBE WORK A I <br />-L'p-l. en_.�u.— II,P. .,-1,\In..�rl f\. <br />usEo BUILDINq` <br />11;4 1{ , <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />PLICATION AND KNOWTHE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <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 CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />i�l Yl A 0 .0 06 <br />LEGAL DESCRIPTION OF PROPERTY ISHOWN BELOW OR ATTACH FOUR COPIES) <br />LOT— BLOCK OF <br />PROJECT ADDRESS <br />e l�A . <br />PLUMBING <br />APPLIC )CITY BUSINESS LICENSE NO. <br />MECHANICAL _ <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS—H. P. EA. <br />BATHTUB <br />REFRIGERATION UNITS—H.P. EA. <br />LAVATORY (WASH BASIN) <br />BOILERS—H.P. EA. <br />SHOWER <br />GAS FIRED AC. UNITS —TONNAGE EA. <br />KITCHEN SINK f DISP. <br />FORCED AIR SYSTEMS—B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS—B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS—B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT— C.F.M. <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS—RAINLEADERS <br />METAL FIREPLACES CHIMNEY <br />SINK SERVICE —BAR. ETC. <br />WOODSTOVE/FIREPLACE INSERT <br />J <br />MIA <br />SUBTOTAL <br />SUBTOTAL 3 <br />_ <br />PERMITf <br />PERMIT f <br />TOTALFEE f <br />TOTALFEE f <br />- <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />