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�,�-�PPLICATION FO:�.��� <br />'"'E""°`"" CONSTRUCTIOM <br />LIT OF <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259•8810 TO BE COMPLETED IN INK- PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION ❑ BU�LDING � MECHANICAL <br />� PLUMBINf: <br />�����n <br />e� <br />❑ SIGN <br />PWM0INGCGNTR4GiOA MaILA00RE55 Ciiv 21P PHONE o LICENSE• � <br />��.��i�ih�' 1 �6 3 ��1� ,r..,,,%�.4 �i — 5.�.�('���� �ih/�C, lf/� �/Jn <br />�E ; <br />cuss or w� � r� <br />❑ NEW ❑ A�DI710N ❑ ALTERATION G REPAIR L� DEMOLI7ION ❑ N/:JODSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION I <br />W L W T1011 OF W OFK ICOSi Oi MAiEFI�LS P W 5 lPB0�1 � <br />C�r� � <br />�S Q% i�! t� (7.�'�.' <br />PLUMBING <br />WATER CLOSET �TOILET� <br />BATHTUB <br />LAVATOPVIWASH OPSIN� <br />SMOWER <br />KITCHEN $�NK 8 DISP <br />DISnwASMER <br />LAUNORY TRA'r <br />CLOTMES �':/ SFIEP <br />URINA� <br />DFINKING FOUNTAIN <br />FLOOF �RAIN <br />BACKFLOH'PAEVENTERS <br />ROOF DRAINS — RA W �EAOC <br />SINK �SERVICE —BAii. ETCJ <br />� ��ONi SELD�CK <br />� I HE(iGBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- � <br />PLICATION AND KNO`N THE SAMETO BE TRUE AND CORRECT. ALL <br />BELOWORPTT�CNLOUPCOPiE51 pFOVISIONSOFLAWSANDI�RDINANCESGOVERNINGTHISTYPE <br />OF WORK WILI 8E COMPLETED WITH WHETHER SPECIfIED HERE• � <br />INORNOT.THEGIiANTINGOFAPERMITDOESNOTPRESUMETO � <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS O� ' <br />ANY JTHER STATE OR LOCAL LAW FEGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. . � <br />SIGNnTUFEUfCONiR:CTO80RAUTH E GENT OATE 1 <br />X r/ /�%i� I�/^ i�/-, i�� � <br />OR <br />iS <br />� <br />MECHANICAL <br />FEE NO. TYPE OF EOUIVMENT FEE <br />A/C — A/NNOLG UNITS — HP <br />REFFIGERATIONiJN1T5—MP EA. _ <br />BOILEPS — 0.T U MP __ <br />GAS FIFEO A C. UNIT$ — B.T.U. <br />FORCE�A�RSYSTEM$—BTU. MEA. <br />WALLHEATERS—BTU. M <br />UNIT HEATERS — B T.0 M <br />EVAPORATIVECOOLERS , <br />CLOTHESORYERS <br />VENTILATION FAN <br />RANGEMOO� <br />WATER NEATER <br />WOODSTOVE <br />METAL FIREPLACE 8 CHIMNEV <br />FIREPUICEINSEflT <br />HEATPUMP <br />GAS PIPING <br />E%HAUSTFAN <br />SUBTOTAL f SU9TOTAL <br />PERMIT S PfRM1T <br />TOTAL FEE S TOTAL FEE <br />—,—_ ___--,—�--'� ��pn CHECK NU:ADER � FEE I NECEIPI NO. <br />BY <br />V�CANISRE <br />❑Y[5 ONO <br />BY <br />BUILDING 5 <br />PLIJMBING <br />MECMANICAL <br />OTHER <br />ST:QE BUILOING SURCMARGE <br />STATEENERGYSUPCNARGE <br />PUBLIC WORKS <br />TOT�>L <br />PROPERTV OWNERS ARE RESPONSIBLE FOR 6ETERMINING ALL <br />FROPERN LINE LOCATIONS AND RELATED EASEMENTS. <br />