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�i ` y ,:',�. <br />,�.E�.,o...� CPLICATION FO�'��� <br />"'"°` ONSTRUCT10�.1 <br />everett PERMIT <br />BUILDING DEPARTMFhT <br />259•8810 TO BE COMPLETED IN INK- PLEASE PRINT <br />everelt <br />e <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL �pLUMBING <br />❑ SIGN <br />owr�eA AIqL AOOR[53 cin <br />ZIP PNONE <br />� � �OG+ � <br />�RCIIIItGTOROkStGNlH MAL�pDR[53 � dt02 <br />GENER�L CON7R�CIOP 1 .n�� MAII AppRESpS Cltt ZIP PMGNE <br />�'"9"'� �^^^'� �`+\ �Ia�i � /� n�..Pw I.w O o..� _ � ,�_ . . LICENSE• <br />lJ NEW Ll ADDITION � ALTERATION C] REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION <br />V�WATION OF WORK�WSTOF 1A�lEH1�L5 PLUS LROOR� <br />Z OOo. Oe <br />OF <br />io�_ <br />PLUMBING <br />J- [..awAL <br />TYFE OF FU(Tt <br />WATER CLOSET �701LET� <br />BATHTUB <br />LAVATORY�WASH BASIN� <br />SHOWER <br />KITCHEN SINK 6 DISP. <br />DISNWASHER <br />C�OTHES <br />UHINAL <br />FOUNTAIN <br />=LOW PREVENTERS <br />6RAIN� — RAINLEi <br />RFRViCF_weo cT <br />IHONTSEiB�CN <br />c[a <br />SUBTOTAI <br />PEpM1T <br />TO7AL FEE <br />on <br />duA <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />PLICATIONAND KNOW THE SAME TO BETRUEAND COHRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORIC WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br />IN OR NOT. THE GAANiING OFA PERMIT DOES NOT PRC-SUME TO <br />GIVE AUTIIORITY TO VIOLATE OR CANCEL THE PROVISIOMS OF' <br />ANYU7H[R STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SICNATUREOFCON7flACTORORAUTHOflIZEDAGENT OATE <br />X,�n 0 /i .,n ' _ _. _ _ <br />nu <br />MECHANICAL <br />7YPE OF EOUIPMENT <br />A/C—A/HN�LGUNITS—H.R �-- <br />flEFRIGEflATION UNITS — H.P. EA. <br />BOILEflS — B.T.0 MP. <br />GAS FIRED A�C. UNITS — B.T.U. <br />FORCEDAIRSYSTEMS—B.T.U. MEA. <br />WALLHEATERS—B.T.U. M <br />UNITMEATEiiS—B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTNESDRYERS <br />VENTILATION FAN <br />FANGEHOOO <br />WATEH MEATER <br />wOODSTOVE <br />METAL FIREPIACE 8 CNIMNEY <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL <br />PFRMIT <br />TO7ALfEE <br />PLAN CHECK NUMBER � FEE <br />VFCANT SIiE FEES � <br />OYES ONO <br />40.OFpWELLINGUNITS BUILDING S <br />PLUMBING <br />unx. ota �oeo <br />MECHANICAL <br />ev <br />OTHER <br />STATE BUILDING SURCHARG <br />STATEENERGYSURCHARGE <br />PUBLIC WOFKS <br />TOTAL <br />PECEIPT NO. <br />FEE <br />PROPER7Y OWNERS ARE RESPONSIBLE FOR DEfERMININO ALL <br />PROPERTY LINE LOCATIONSAND RELATED EASEMENTS. <br />