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�, <br />�, �� <br />everett <br />BUIIDING DEPARTMENT <br />� 259-8910 <br />�PLICATION f01� <br />CONSTRUCTION <br />P�RMIT <br />TO BE COMPLETED IN INK - PLEASE PRINT <br />� ' n nciunuTloN ❑ COMBINATION <br />i <br />� <br />❑ BUILOING ❑ MECHANICAL ❑ PLUMBIN(i <br />❑ SIfiN <br />pENEMLGOHTR�GiOX M�II �ODRE55 ��T'� zi� PHONE LICENSE • <br />MECN�NIC�LGONTP�CiOR M�R�O�RE55 ���Y z�P PHONE IICEN3E• <br />IiP <br />CU�O o� wunn <br />� NEyy ❑ ADDITION ❑ ALTERATION ❑ RFPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT BUIIDING NELOCATION <br />V�LU�TIONO M�iERi�L5PW5L�BOPi ' <br />/LYIMING <br />&NK <br />TpAY <br />�iZ' <br />•PPUC�IION�CC BY <br />�'uMb�K d- MPC�4qlCa( �,- re ���al�,l 6�,/ <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />PL ICATION AND KNOW THE SAME TO BE TRU E AND CORRECT. ALL <br />ouncoo�esi PROVISIONSOFLAWSANDORDINANCESGOVERNIN6THISTYPE <br />r�' � OF WORK WILL BECOMPLETED WITH WHETHER SPECIFIED NERE- <br />' IN OR NOT. THE GRANTING OF A PERM IT DOES NOT PRESUME TO <br />GIVE AUTHORITY 10 VIOLATE OR CANCEL THE PROVISIONS OF <br />ANV OTHER S7ATE OH LOCAI LAW REGULATIN6CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTfiUCTION. <br />SIGN�TURE OF LONiR�CTOR OR AUTNOR12ED �GENT DATE <br />�. <br />rorunc si i <br />RE�N SETB�CR SIOE SET&1GR <br />LOf�RE� WG�Hi51TL <br />OYES ONO <br />OCCUVINGYGROUP NOOFOWELlINOUNIT3 <br />NO Oi STORiE3 M�%ACC LO�D <br />RED ❑ VES ❑ NO <br />PLANS CHEGNEO BY APPR FOR ISSU�MCE BY <br />I�LENSE Nb <br />MECHANICAL <br />TYrt Of !� <br />NC — A/HNOLO UNIT9 — <br />BOILEFS — B.T.0 iH.P <br />OAS FIRED A.C. UNITS — B' <br />FORCEO AIR 9YSTEM3 — B. <br />WALL NEA7EA$ — B.T.U. <br />UNIT NEATERS — B.T.U. <br />EVAPOR�TIVE COOLER9 <br />CLOTMESDRVEH$ <br />VENTIUTION FAN <br />qANOEHOOD <br />WIITER HEATEP <br />WOODSTOVE <br />METAL FIREPUCE 6 C�"MI <br />FIREPLACEINSEPT <br />HEATPUMP <br />OAS PIPINO <br />E%MAUSTFAN <br />sw <br />PLAN CMECK <br />FE <br />BUILDING <br />PLUMBING <br />MECMANICAL <br />OTHER <br />STATE BUILDING SURCHARGI <br />STATEENERGYSURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />FEE <br />S <br />M EA. <br />M <br />M <br />RECEIPT NO. <br />PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMININO ALL <br />PROPERTY LINE LOCATIONSAND RELATED EASEMENTS. <br />