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fM ErnprNn <br />CIPI OF <br />everett <br />BUILDING DEPARTMEIJT <br />2,59-8810 <br />�<:��P��c�,-rioN Fa.. <br />CONSTRUCTION <br />PERMIT <br />TO BE COMPLETED IN INK • PLEASE PRINT <br />n oEnnouTlON ❑ COMBINATtON ❑ BUILDING ❑ MECHANICAL ia.PLUMBING <br />everotl <br />� <br />❑ SIGk <br />��^ <br />u�p nbun[s5 G�� Im nnoNF. UCENSt• <br />(1VICMt GUItl1UC�0� <br />MLf.�UN�f.�L G011�4�LiUq M�II �00t1ESS CIIY I�P PnONE IILENS[ • <br />4WMOiNqGUqIpN.IU�� nlNl nUU�iL"+.i L�IY 81' I•uUNI I�LLNSI. <br />� "J���)u'-i%•c."ft ro �'-•Y 'S�j�i �P��ir....��•f��� 51_�•L-'7 '��y;?Z�'l- AI-!'�'•il'-� <br />cinssonvonv � �? JL <br />FL] NLW ❑ �DOIIION ❑ ALTERATION ❑ AEf'AIR ❑ DEMOLITION ❑ WOODS70VE/FRPL.INSERT ❑ BUILDING RELOCAilO�J <br />WIWt�UqOrwOm�Co510�rA.f11R�<tsPlust�00ni,/ ' I <br />� LI <br />J <br />'J <br />�. rti L71' <br />io�—eiock_ <br />PPOlEC1�00NC <br />PLUMBING <br />NO. TYPE OF F�XTU <br />� WATER CLOSET ��OILET� <br />BATHTUO <br />/ U�ATORY IH'A511 BASINI <br />SHOWER <br />KITCHEN SINK d DISP <br />OISHWASHER <br />LAUNORYTRAY <br />CIOTMES W�SHER ' <br />UAINAL <br />FLOON D�AIN _ <br />BACNFLOw PREVENTERS <br />Z� ROOFOf1�1�N5-PnINIEADeRS <br />SINK �SERVICE - OAR ETC � <br />! 7 /�...Hl�l.9'd.i.✓'i ��/ <br />SUB <br />0 <br />ITEM <br />I TOTAL FEE <br />���o�irse�o:r.i -� �nE�nseie�en <br />U9f <br />SilC O� O�DG <br />Al l"I �1::.1IOf! aLf. Ilr <br />I HER[BY CERTIFY THAT I hiAVE READ AND EXAMINED TI115 AF• <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl <br />PROVISIONS OF LAWSAND ORDINANCESGOVERNING THIS TYPE <br />OF WOAK WIIL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUThIORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANV OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. . <br />$IONAIUPE Uf CON704CTOR O� ylOf112ED AGENT [1RiE <br />"�;t'�,��-��'--� �� o�"- �" -s, <br />�ec� m�uac un <br />MECHANICAI <br />FEE NO. TYPE OF EOUIPMENT <br /><'�-� ' AiC-AiMNDLGUNITS-HP. <br />REFRIGERATION UNITS - li P. EA. <br />�-� � � �OILERS-B.T.UMP. <br />GAS FIRED A�C. UNtTS - B.T.U. <br />FORCE� Alil SYSTEMS - B.T.U. M EA. <br />WALIHEATERS-BS.U. M <br />�- 1 1 UNIf11EATERS-OT.U. N <br />EVAPORATIVE COOIERS <br />CLOTHESORYERS <br />VENTILAiION FAN <br />- '��� R�NGEHOOD <br />WATEii HEATER <br />'� 1 WOODSTOVE <br />METAI FIAEPLACE 8 CHIMNEY <br />v �t� flREPLACEINSERT <br />� / -� HEAi PUMP <br />r-� �^,L, GASPIPING <br />E%NAUSTFAN <br />�ll V [ JG 1 Yn4n <br />IbIRpCR VRCRtlIA�IE <br />I]vCS I1N0 <br />pCfUPANCYGROUP ��0 Of DWFLLIN <br />NO Uf $IORIES MRK OCL IORD <br />RED ❑ YES ❑ NO <br />�`I/NSCIIELNEDBY ��'�����OIIISSU <br />SUBTOTAL <br />OER/AIT <br />PLAN I;MECK NUMOEH I FEE I AECEIPT NO. <br />DUILDING <br />UNitS <br />PLUMBING <br />MECMAIJ�CAL <br />OY <br />OTIIER <br />SfATE BUILDING SURCHARG <br />STATEENEPGVSURCHARGE <br />PUOLIC WOiiKS <br />TOTAL <br />S <br />PROPERTY ON'NERS ARE fiESPONSIBIE FOR DETEIIMINING ALl <br />PROPEfiTY LIt�E LOC�TIONS AND PELAIED EASEMENTS. <br />l <br />r; <br />