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�: ;M I. . <br />��PPLICATION FOi:' <br />'"'`"'°"'" CONSTRUCTION <br />pr o. <br />everett PERMIT <br />BUILDING DEPARTMEN7 <br />259•8810 TO BE COMPLETED IN INK- PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING �"MECHANICAL <br />Q"PLUMBING <br />❑ SIGN <br />M�I� <br />PNONE <br />❑ NEW ❑ AODITION � ALTERATION ❑ REPAIR ❑ OEMOLITION ❑ WOODSTOVEIFFPL.INSERT ❑ BUILOINa RELOCAl10N <br />4ALU�TtON OF WORN �COST OF MATEHULS P�US L�BORI <br />♦ <br />�o�—e�ocK— <br />PROJkCT <br />PLUMOING <br />8 OISP. <br />URINAI. <br />DRINKINO FOUNTAIN <br />FLOOR DRAIN ' <br />BACKROW PREVENTERS <br />ROOF DR�11NS — AAINLEAOERS <br />SINK (SERVICE — BAR, ETC.) <br />ZONE � IIOT�REA <br />TVPE OF CONST <br />I HBAEBY CERTIFV THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW TH E SAM E TO BE TRUE AN D CORRECT. ALL <br />PROVISIONS OF LAWSAND ORDINANCES GOVERNING THISTYPE <br />OF WORK WILL BE COMFLETED WITH WHETHER SPECIFIED HERE• <br />IN OR NOT. THE Gf;ANTIP:G OFA PERMITDOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTH ER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGN�TUH CONTRRCTOROHAUTHORIZEO�GENT DRTE <br />X . /�., „ ln A �l `7�n.��G'� <br />APPLIC�NTS CITY BOSINE94 L�CEN9E NO <br />MECHAN�CAL <br />MO. TYPE OF EOUII <br />A/C — A/HNDl6 UNITS — H.P. <br />REFRIGERATION UNITS — H.P <br />BOILGRS — B T 11 /N P. <br />rvnctu n�n srs � ema — <br />WALL HEATERS — B.T.U. <br />UNIT HEATERS — B.T.U. <br />EVAPOFATIVE COOLERS <br />CLOTHES�HYERS <br />VENTIU710N FAN <br />AANGEHOOD <br />WATER HEATER , <br />HEAT PUMP <br />OAS PIPINO <br />E%HAUSTFAN <br />PLAN CNECK NUMBER <br />6 CHIMNEY <br />SUSTO7AL <br />y[RMIT <br />TOTALfEE <br />I F� <br />M <br />M <br />RECEIM NO. <br />V�C�Ni51fE FEES YALUATION FEE <br />OYES �NO <br />NO.OFDWELIIN�UNITS BUIL�ING S <br />PLUMBING <br />Mea. occ. �o�o <br />MECHANICAL <br />OTHER <br />STATE BUILDING SURCMARGE <br />STATEENERGVSUPCHARGE <br />APPR. FON ISSUANCE BY <br />PUBUC WORKS <br />TOTAL <br />PROPERTV OKNERSAflE RESPONSIBLE FOR DETERMINING ALL <br />PROPERTY LINE LOCATIONS AND RELATED EASEMENTS <br />