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_ __,.,.�:�a__ ,._ <br />�'�PLICATION FOt���r� <br />'"'E'""""' CONSTRUCTION °"°"" <br />, an, os <br />� everett PERMIT ��'+ <br />� BUILDING DEPARTMENT <br />25P•8810 TO BE COMPLETED IN INK- PLEASE PRINT <br />i <br />? ❑ DEMOLITION �.COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />� OWNER MMl �DORE55 Cltt 21P PMONE <br />�E6AERct� alc 14�V n(•3y �lai'' �cat1� QSr/uS SSl�-A2�3 <br />MEGM11H1G�L GONTMGTOq 1nMl �O�RE55 CIIY 21P PNONE �IOENSE • <br />IIUM�INOCONTR�CiOR M1ILAUDRE55 CIN 2iP PIIONE L1LEN8E• <br />Qkcmt..Soa� �z4 W•Cr9sr.�a f,veser 9F�K �Y3-rss�- �ki��s �y�� <br />GL�SS F WORN <br />� NEW ❑ ADDITION ❑ ALTER4TION ❑ HEPAIR ❑ DEMOLITiON G WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION <br />1 <br />(�F S <br />PLUM/ING <br />i <br />?:.^;i�, <br />OR <br />ROOR pRA1N ' <br />BACKFLOW PREVENTERS <br />ROOF ORAINS — RAINLE/ <br />SINK I�NVICE — BAR. Ei <br />�/ <br />uec i e <br />�rrE oF � a . — <br />' .�N <br />a�te or Koa <br />/O�i O �i� <br />� FIRE SPRINKIERS REa <br />. APPLIC�710N �CC. BY <br />KRiNi <br />?A/ <br />� <br />✓� <br />�- 3 <br />5� <br />ANT SITE <br />i4 ONO <br />OF OWELLINO UNIT6 <br />� <br />oca w�o <br />�� <br />FOR 1lSII�HGE <br />LG <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />PL ICATION AND KNOW TH E SAME TO BE TRU E AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNI NG THIS TYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br />IN OR NOT. TH E GRANTI NG OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEI THE PROVISIONS OF <br />ANY OTHEfi STATE OR LOCAL LqW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTfiUCTION. . <br />SIGNATUREOFCONTRACTORORAUTHOHIZEDAGENT O�TE <br />X 1�a�-:,( �4•�1.G�lw�� <br />wrrucenr5cirrau5inE5SLiCEN4EN0 ' <br />MECHANICAL <br />NO. TYPE OR EOUIPM! <br />A/C — AMNOLG UNITS — M.P. <br />REFHIGERATION UNITS — M.P. EA <br />BOILERS — B.T.II.M.P. <br />OAS FIRED A.C. UNITS — B.T.U. <br />FORCED AIH SYSTEMS — B.T.U. M EA. <br />WAILNEATERS—B.T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTMESOHVERS <br />VENTILATION FAN <br />RANGEMOOD <br />WATERMEATER <br />wOODSTOVE ` <br />METALfffitLfO/' CHIMNEY <br />FIHEPLACEINSERT <br />MEATPUMP <br />OI�S PIPIN� <br />EXHIIUST FAN <br />MN CHECK NUMBEH <br />WB TOT/LL <br />PERANT <br />TOTALFlE <br />�FEE <br />VALUATON <br />euaoiNa <br />vwMewc <br />MECNANICAL <br />OTHER <br />STATE BUILDIN6 Sl1HCMARG <br />STATE ENER(iY SURCHARGE <br />PUBLIC WORK9 <br />TOTAL <br />HECEIPT NO. <br />PROPERTY OWNER3 ARE RE3PON91BLE FOR DETERMININO ALI, <br />PROPERTV LINE LOCATIONS AND REUTED EA9EMENT3. <br />