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i.l.... <br />�:=APPLICATION F� <br />�^.Ew`°�.° CO N ST�' U CT I O M1l <br />CITY OF <br />ever�tt PERMIT <br />BUILDING DEPARTMENT TU 8E COMPLETED IN INK- PLEASE PRINT <br />259•8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING � MC-CHANICAL � PLUMBING <br />PMONE <br />everett <br />e <br />❑ SIGN <br />MAIL�DDRF.55 ��TM Z�P '� <br />OWNER � �i I .ji ) �}-,'jr ,�( t� <br />� 1`»�C� •���(.���llll`-s'�Yl - •��I"� �/) �ilc�r.-��(1. f t (� � <br />APGHITEGT OR �ESIONEH <br />MAlLA00RE55 CIIV 2i� PHONE � <br />M�IL�DORE55 CiIY ZIP PNONE LIGENSE+ <br />GENERALCONTR�GTOR , <br />M�ILADURE55 CIIY 21P PMONE LICENSE+ <br />MECN�NIC4LCONTR�CTOq A,ly��'(�� I�I/_����A-I�—i�J.�J'V _)(1L/I <br />nJ�--rl�rzn� n� ct���iP c� -i<<;),� r- �tri �i i, < <� ��� o� <br />M�IL��DAE55 LiY � 11V PIONE /A� ) LICENSE ( <br />PLl'MBINOGOHiRAGTOR � . / A,��ill�l�C�L.I��-II`�/ ; <br />V <br />GLA55Oi WOAK ' <br />❑ NEW ❑ ADDITION �� ALTERATION ❑ REPAIR ❑_JEMOLITION ❑ W�10DSTOVE/FRPL.INSERT ❑ BUILDING RELOCF710N <br />WLUATION OF WOAK�WST OF MATERULS PWS LABORI <br />�_ <br />�or—e�oc�.— <br />1 LL ,�J�C(C <br />VROJEGT�DDRESS <br />S�-�� �'� ��� ��� L � <br />PLUMBING <br />NO. TYFE OF FIXTURE OR ITEM <br />WATER ClOSET (iOILETI <br />BATMTUB <br />I,AVATORV (WASM BASIN� <br />SNOwER <br />KITCMEN SINK 6 DISP. <br />OISMWASHER <br />LAUNDRVTRAV <br />�— CLOTHES WASHER <br />URINAL <br />OR�NNING FOUNTA�N <br />FLOOR DflAW � <br />BACKFLOW PREVENTERS <br />ROOF DRAINS — RAINLEA�ERS <br />aiuKisFaVICE-9AR.ETC.) __ <br />ACC BY <br />\ <br />SUBTOTAL S <br />PERMIT f <br />TOTAL FEE S <br />�AE� - VAC�NT SITE <br />OYES ONO <br />uPANLYGPOUP NO.OFOWEL <br />oGc. <br />I HEREBY CERTIFY THAT I HAVE READ AN� EXAMINED THIS Ap- <br />PLICATION AND KNOW THE SAMETO BE TRUEAND CORRECT. ALL <br />PROVISIONS OF LAWSAND ORDINANCESGOVERNING THISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br />IN OR NOT. THEGRANTING OFA PERMITDOES NUT PRESUMETO <br />GIVE AUTHOfiITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANYOTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. . <br />SIGNATU���� �� RpUTHORIZE�AGENT /!�E_ ��_�f� <br />X <br />4PPLICRNTS CITY UUSiNE 55 ULENSE rv0 <br />MECHANICAL <br />A/C — A/MNDlO UNITS — M.P. <br />REFRIGERATION UNITS —H.P. F <br />BOILERS — B.T.U/H.P. <br />GAS FIREU A.C. UNITS — B.T.U. <br />FORCED AIR SVSTEMS — B.T.U. <br />WALL HEATERS — B.T.U. <br />UNIT MEATEFiS — B.T.U. <br />CLOTHESDRYEPS <br />VENTILATION FAN <br />qANGEHOOD <br />WATER HEATER <br />WOODSTOVE <br />METAL FIR�PLACE 6 CHIMNEY <br />FIREPIA�:EN�BBlIT C"7�'-i <br />HEAT PUMP <br />GAS PIPING <br />E%H�115T FAN <br />PLAN CHECK NUMBEA <br />SUB T�)TAL <br />PERMIT <br />TOTALFEE <br />IFEE <br />BUILD�NG � <br />PUIMBING <br />MECHANICAL <br />OTHER <br />STATE BUILDING SUACHARGE <br />STATEENERGYSURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />M <br />M <br />FE8 <br />RECEIPT NO. <br />PROPERN L�INE LOCATONS ANDNRELATER EASEMENTIS ING ALL <br />. . ., .. .....� <br />