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___ _ _ <br />. ► � --- -�_ <br />rn. r...y,«� <br />Ci^f OF <br />everett <br />BUILDING DEPARTMENT <br />259-8810 <br />•.PPLICATION FO.. <br />CO►NS�RUCTION <br />PERMlT <br />TO BE COMPLETED IN INK- PI„EASE PRINT <br />❑ DEMOLITION ❑ COMBINATIOfV <br />,,,�.�u ei�Gf�G i�� �I� NJi��. c:;oFc= <br />�'r:-i <br />ORU! <br />UILDING ❑ MECHANICAL <br />-'_� c. l 2 727. �- <br />❑ PIUMBING <br />�/ PNO/MIC /� / <br />�~ (`/WN�' CS%. ��/�i (/�i� � ��% <br />= �• Gwnw <br />evrretl <br />� <br />❑ SIGN <br />C,k'.EH4lCG'dq<CiOP MI.IIaD�FCSt ��n. <br />wu-I� �1GC ��Gn�C�� P 0 ��il /DIGr i�� t�v w�owe �icer�sc. <br />� mm'1 SV� � Zsz-,ad� G,;c�,,,,M 15'l /3w <br />VtCM4N:'.4lCON1HdCTnR M�ILAODRE55 OtY <br />���� ���ONE UCF�KF • <br />PLUM8INGCGNiR4GiOR MAq�DOFE55 GiY p�p <br />m�orre �,r � r�se . <br />��A55OF WORN ' <br />❑ NEW � ADDITION A�TERATION ❑ qEPAIFl ❑ pEMOLITION ❑ WOODSTOVE/fRPL.INSERT ❑ <br />ucuo�+o��.oe.,cos*oreur r< n BUILDING FELOCl+TIOH <br />E�� L LUSIABORi <br />�00 • p0 <br />D[SCRIBE WORN <br />c��f r, � �` �i�-n B� � � /�,t� u-� 1 �� <br />use o� em�omc <br />OfY; CC- <br />GNooEAiv <br />�c�_ <br />PLUMBING <br />NO. <br />WnTER CLOSET iTOILET� <br />BATMTUB <br />�AVATORVIWASH BASIN� <br />SMOWER <br />KITCMEN $INK d OISP <br />OISHwnSHER <br />LAUN�RVTRqV <br />CLOTHES WASHER <br />DFINNING FOUNTAIN <br />FLOOR DRnIN <br />BACNF�OW PREVE^ITERS <br />ROOF DRA!tJ5 — qAINI EAOF <br />SINK �SERVICE — BAR. ETC ) <br />�r5t ra.rt <br />rvr( Of C <br />54E ov B� <br />NRF SPI <br />• . . �-ir•.:. � <br />� • <br />OR <br />I HER[BY CERTIFY THAT ! HAVE READ AND EXAMINED THiS AP� <br />PLICATION AND KNOW THE SAME 70 BE TRUE AND CORFECT. ALL <br />aF<�*<c�rouncowesi PROVISIONSOFLAWSANDORDINANCESGOVERNINGTF'ISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIEC: HERE� <br />IN OR NOT. THE GRANTING OF A PERMITDOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULA?ING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />— $IG4ACUqE Oi' GONiFaCipq OR AUiMOPiZEO AGENT p51E <br />_ � �. rrr_ �' ��r��' /D- 8- 8 7 <br />MECHANICAI <br />FEE NO. TYCE OF EOUIPMENT <br />A�C — AMNDLG UNIT$—M � <br />REFRIGERA710NUNITS—HP EA. <br />BOIlEPS — 0.? U �M P <br />GAS FIRED A C. 4NIT5 — B TL.� <br />FORCEDAIRSYSTEMS—BTU. M <br />WALLIiEATERS—BTU M <br />UNITHEATERS—OTL M <br />EVAPORATIVE COOLERS <br />CIOTHESDRYERS <br />VENTILATION FAN <br />RFNGEHOOD <br />WAT[RHEATER <br />WOODSTOVE <br />METAL FIREPLACE A CHIMNEV <br />FIREPLAfEINSERT <br />FrAT PUMP <br />GA$ PIPING <br />E%MAUSTFAN <br />SUBTOTAL s <br />PEPMIT f <br />70iAL fEE .{ <br />NC4q5E�9PCn 5@E SCiBACe <br />�oi anu <br />�'ACAui $li[ <br />�res No <br />OCCUVnNGYGR011P NOOLpWFILINGI1NlTS <br />NO O� SiOnIES MAR OGC L040 <br />CiAHS <br />4f'(�N �nRIjSU��ICE <br />G �- <br />4'LAN CMECK NUM�ER <br />BWLDING <br />PLUMBING <br />MECHANICAL <br />OTMER <br />STATE BUILDING <br />SUB 70TAL <br />PERMIT <br />TOTALFEE <br />�fEE <br />STATEENERGYSURCNARGE <br />r 6'BLIC WOFK$ <br />rora� <br />VALUATION <br />5 i'i/1/1 f <br />I7ECEIGT NO. <br />FEE <br />PFJF'ERTY OWNEFS ARE RESPONSIDLE FOF C�ETERMINING ALL <br />PPOPERTY LINE LOCATIONS AND R[LATED EASEh7E1JT5. <br />