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fMEwrpn�n �•r'PLICATION FQJI� <br />��noF CONSTRUCTION <br />everett PE R M 1 T <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK • PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ 6AECHANICAL <br />❑ PLUMBING <br />���rcn <br />e <br />❑ SIGN <br />PLUMBINGCONTRALTOR MRILApDAESS CITY LIV PIIONE �ICENSE• <br />iL11.1� V � W V XR <br />❑ NEW ❑ ADDITION <br />IRWRTION OF WORN �LOST 0� MI <br />ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODS70VE/FRPLINSERT ❑ Ruuniur GFIl1!`GTI(l�l <br />/��-���•� <br />LEGAL OESGRiPTION OF PN <br />�or_ e�ocK— <br />IOJECTADDRE55 <br />��r�- ��-`• <br />PLUMBING <br />CLOSET(7011Ei) <br />LAVATORV�WASH BA! <br />SHOWER <br />KITCHEN SINK 6 OISP. <br />URINAL <br />DRINKING FOUNTAIN <br />ROOF DRAINS — I <br />SINK ISERVICE — <br />USE20NE <br />SiZE Oi BIDG <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED TH�S AP- <br />PLICATION AND KNOW THE SAMETO BETRUEANDCORRECT. ALL <br />BEIOWORRTTRCMFOURCOPIESi PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE- <br />IN OR NOT. THE GRANTINCa 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 PERFO ANCE OF CONSTRUCTION. <br />SIGN U OF C R AUTHORIZED NT OATE <br />c %�-f�� <br />� <br />RPPLICRNTS CItY BUSINE i NSE NO <br />MECHANICAL <br />NO. TYPE OF ECUIPMENT <br />� A/C — AiHNDLG UNITS — N.P. <br />REFRIGEPATION UNITS — Ii.P. EA. <br />BOILEPS — B.T.U./N.P. <br />GAS FIREG A.C. UNITS — B.T.U. <br />FONCED AIR SVSTEMS — B.T.U. M EA. <br />WALL MEATERS — B.T.U. M <br />UNIT MEATERS — B.T.U. M <br />EVAPOPATIVECOOLERS <br />CLOTMESORYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEV <br />FIREPLACEINSEHT <br />HEAT PUMP <br />GAS PIPING <br />EXMAUSTFAN <br />SUSTOTAL i SUBTOTAL <br />PERMIT f PEPMIT <br />TOTALfEE f TOTALFEE <br />,...�.e...., �.... ..�.e.... 1 PLAN CNECN NUMBER I FEE <br />LOTRHEA <br />iT OCCUPANGYGROUP <br />NJ OF STORIES <br />IKLERS REOUIRED ❑ VES ❑ <br />aCC BY PLANSCHECKEDBY <br />Vr1CPNT SITL <br />❑YES ONO <br />NO.OF pWELLING UNITS <br />MA%.00C. �OAp <br />APPR.FORISSUANCE BV <br />BUILDING S <br />PLUMBING <br />MECHANICAL <br />OTHER <br />S7ATE BUILDING SURCHARGE <br />STATEENERGVSURCHAFGE <br />PUBLIC WORKS <br />TOTAL <br />PECEIPT NO. <br />PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING ALL <br />PROPERN LINE LOCATIONS AND RELATEU EASEMENTS. <br />