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,.., ..: . <br />, i��:, <br />i:`PPLICATION F01:-`=� <br />'".E"'°"'" CONSTRUCTION <br />cin or <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259•8810 TO 8E COMPLETED IN INK • PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING �CHANICAL ❑ PLUMBING <br />UN <br />M�I� <br />���nn <br />e <br />❑ SIGN <br />GkNEMICONIfl�G101i M�IL ��UIIC55 411Y 111' �9�ON[ LICENSE • <br />MNl <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIf7 ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSEHT ❑ DUIIDING RELOCAiION <br />v�wenor� or wonK�cosr or M•�en�e�s r�us ieoom <br />1VORa <br />� n <br />�o�- <br />PLUMSING V <br />NO. TYPE OF FIXTI <br />WATER CLOSET ITOILET� <br />BATHTUB <br />1.AVATOHY IWASM BASIN� <br />KITCHEN SINK 6 DISP. <br />OISFIWASMER <br />LAUNDRY TRI1Y <br />CIOTMES WASMEH <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR ORI11N � <br />ROOF ORAINS — <br />SINK 1SERVICE — <br />fRONTSETB�Lk <br />USElONE <br />SUSTOTAL <br />PERMIT <br />TOTALFEE <br />NO OF STORIES <br />0 <br />� <br />f <br />f <br />SIOE SETB�CR <br />V�C�NT SIIE <br />OYES ONO <br />NO. Oi DWELLINfs UNITS <br />M�k OLC. LOAD <br />•PPR FOR ISSO�NCE BY <br />I HEREBY CERTIFY THAT I HAVE FEAD AND EXAMINED THIS AP• <br />PLICATIONAND KNOW THE SAMETO BETRUE AND CORFECT. ALL <br />PROVISIONS OF LAWSAND ORDINANCESGOVERNINGTHISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br />IN OR NJT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOIATE OR CANCEI THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL lAW REGULATING CONSTHUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. . <br />SIGNAIURE OF CONTRaC OR O AUT OnIZED AGENi DnTE <br />X���� �20���- <br />APPIIf.�NiS CIiY BUSINESS IiCENSE NO <br />MECHANICAL <br />TYPE OF EOUIPMENT <br />A/C — AMNDLG UNITS — M.P. <br />REFRIGERATION UNITS —H.P. EA. <br />BOILERS — B.T.U.MP. <br />GAS FIRED A.C. UNITS — B.T.U. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WAILMEATERS—B.T.U. M <br />UNIT MEATENS — B.T.U. M <br />EVAPORATIVE COOIERS <br />CLOTHESURYERS <br />VENTILATION FAN <br />RIINOE HOOO <br />w000srove <br />METAL FIREPLACE 8 CMIMNEV <br />FIREPIACE INSERT <br />MEAT PUMP <br />�AS PIPING <br />E%NAUSTFAN <br />SI1B TOTAL <br />P[NMIT <br />TOTALFEE <br />PIAN CMECN NUMBEH �FEE <br />eui�owc 5 <br />PLUMBING <br />MECHANICAL <br />OiHER <br />STATE BUILDING SURCHARGE <br />� <br />STATEENERGVSURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />RECEIPT NO. <br />FEE <br />PROPF.RN OWNERS ARE RESPONSIBLE FOR DETERMINI NG ALl <br />PROPEiiTY LINE LOCATIONS AND RELATED EASEMENTS. <br />