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�N Ersrp�N� <br />�ITY OF <br />everett <br />BUILOING DEPARTMENT <br />259•BB 10 <br />HPPLICATI�N FO�.' <br />CONSTRUCTION <br />PERMI� <br />TO BE COMPLETED iN INK- PLEASE PRINT <br />everetl <br />� <br />❑ DEMOLITION ❑ COM8INATION ❑ gU1LDING ❑ MECHANICAL ❑ PLUMBING O SIGN <br />OWNL� MRILADORESS CIiV 21P PHpNC <br />n i i .. �—i _ �r-� .��al:c.-.,i s� t�c��7i— i5'%!i� �s`S-.S�77 <br />tiv <br />GlNEf4L f,ONIl1RW OP <br />Mnit aooRE55 pir Lr �'��nN[ uf.ENst • <br />� N�yy �A�DITIC <br />rsW�tiOH or wonK IcoSt or <br />'lf Vf.liltlE WOHR <br />❑ AITERATION ❑�EPAIR ❑ DEMOLITION �. WOODSTOVE/FRPL.INSERT ❑ BUILOING RELOCAiION_ <br />Y ._S'•.,�/f f � i �/`/ yJi< <ry -C_. <br />�[pp{,p SCRiPfIONOFPROPERi �SHOWNOELOWOR�ITRCHfOURCOPIE51 <br />�p�RE55 <br />PLUMBING <br />TYPE OF FII <br />WATER CLOSET �TOILI <br />BATHTUB <br />LAVATORY�WASHBA! <br />SHOWER <br />KITLNEN SINK 6 OISP. <br />LAUNDRYTRAV <br />CIOTHES WASHER <br />UFIN4L <br />FLOON <br />D�CKFLOW PREVENTEfiS <br />ROOF ORAIN$ — RAINLE/ <br />SINK ISERVICE — BAR, E7 <br />���UNi SE10�Cn <br />CONSi <br />;n�ION �CC Bv <br />� <br />I HERE-BY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP� <br />PLICA'TION AND KNOW TH E SAME TO BE TFUE AND CORRECT. ALL <br />PROVISIONS OF LAWSAND OR7INANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLETE� WITH WHETHEA SPECIFIED HERG <br />IN OR NOT. THE GRAN TING OF A PERMIT DOES NOT PR[SUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIOMS OF <br />ANYOTHER STATE OF: LOCAL LAW REGULATING CONSTRUCTION <br />CR THE PERFORMANCE OF CONSTqUCiION. . <br />$IGNATUREOFCONiNACTONO11AUiMORIZEOFGEN� [141@ <br />X/i(" ai�ibn-,f C, Z'���/L:'�li.-._r- iG''�/ r)�� <br />MECHANICAL <br />FEE NO. TYPE OF EOUIPMENT <br />AIC — A/FINOLG UNITS — HP <br />REFRIGERATION UNITS — MP. EA. <br />BOILEFS — B. i.0 MP. <br />GAS F'9ED A�C. UNITS — B.T.U. <br />FOflCEO AIR SYSTEMS — BS.U. M <br />Wq��HEATERS—B.T.U. M <br />UNIfHEATEHS—B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHESORVEP.S <br />VENTIIATION FAN <br />RANGEIi000 <br />WATER HEATER <br />WOODS70VE <br />METAI FIPEPLACE 8 CHIMNEV <br />FIREPU+CE INSERT <br />HEATPUMP <br />GAS AIPING <br />E%HAUSTFAN <br />SUBTOTAL f <br />PEAMIT f <br />TOTAI FEE s <br />n SEIB�GR SI�E 5[TBAGK <br />AR�A VRCANLSIfE <br />❑vE5 �NO <br />:UPANGYGPOUP NO.OFDWE:LING <br />Of STORIES MP% OCQ lOAO <br />) ❑ YES ❑ NO <br />vI5 LHECNED BY �I'PR. FOR �5511�I <br />SUBTOTAL <br />PERMIT <br />TOTALFEE <br />PLAN CMECK NUAIBEH I FEE <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE 6UILDING SURCHARG <br />STATCENERGYSURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />$ <br />RECEIPT NO. <br />FEE <br />PROPER7Y O NE LOCAiONS ANDNRELATED EASEMENTIS I NG ALL <br />