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t.�'PLICATION FO�-��� <br />,".F".,°`"° .CONSTRUCTION <br />cin oF <br />everett PE RM IT <br />BUILDING DEPARTMENT <br />259•8810 TO BE COMPLETED IN INK- PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING �MECHANICAL <br />MAIL <br />❑ PLUMBING ❑ SIGN <br />� <br />�s °� <br />DESCRI�E WORN <br />InsrALL 2 ca Rc-s� �� FA <br />USE OF BIIILOING <br />�oi— <br />PLUMBING <br />WATEP CLOSET �TOILE <br />BATHTl1B <br />LAVATORYIWASMBAf <br />SHOWER <br />NITCHEN SINK Q �ISP. <br />DISFIWASHER <br />LAUNDPVTRAV <br />CLOTHES wASHER <br />URINAL <br />�RINKING FOUNTAIN <br />ROOR DRAIN - <br />1NpNTSE70�GN <br />OF <br />/VPlICR110N I: BY <br />— BAR. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAUE TO BETRUEANDCORRECT. ALL <br />PROVIS�ONS OF LAWSAND ORDINANCES GOVERNING THISTYPE <br />OF WORK WILI BE COMPLETED WITH WHETHER SPECIFIEO HERE- <br />IN OR NOT. THE GHANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAI LAW REGULATING CONSTRUCTION <br />OR THE PERF RMANCE OF CONSTRUCTION. , <br />SIGNATI1flE OF C TRACTOR O T ORIZ AGENT OATE <br />X t�ti", � -� <br />�PPLI T. ITY �OSIN 5 Et E NO <br />MECHANICAL <br />OR ITEM FEE NO. TYPE OF EQUIPME <br />A/C — A/HN04G UNITS —H.r <br />PEFRIGERATION UNITS — H.P. EA. <br />OOILERS — B.T.U./H.P. <br />GAS FIREO A.C. UN�TS — B.T.U. <br />FORCED AIR SYSTEMS — B.T.U. <br />WALL HEATERS — B.T.U. <br />UNIT HEA7ERS — B.T.U. <br />EVAPOFATIVE COOLEflS <br />� CLOTHESORYERS <br />VENTILATION FAN <br />AANGEHOOD <br />WATER MEATER <br />ag WOOU STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEATPUMP <br />GAS PIPINf; <br />SUBTOTAL <br />VERMIT <br />TOTALFEE <br />LOTAREA <br />OCCUPANCY GRI <br />NO OF STONIES <br />BY <br />VACANT SITE <br />OYES ONO <br />PLANCNECKNUMBER <br />SIIB TOTAL <br />PCRMIT <br />TOTALFEE <br />IFEE <br />M EA. <br />M <br />M <br />FEE <br />RECEIPi NO. <br />BUILDING 5 <br />PLUMBING <br />MECHANICAL � <br />OTHER <br />STATE BUILDING SURCHARGE <br />STATEENEPGYSURCHARGE <br />PUBLIC WORKS <br />TOTAL � <br />PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING ALL <br />PROPERN LINE LOCATIONS AND RELATED EASEMENTS. <br />� <br />� <br />r� <br />