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`��PPLICATION FO�:`�' <br />'"'E"'°'"" CONSTRUCTION <br />un or <br />everett PERMiT <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK- PLEASE PRINT <br />❑ OEMOI.ITION ❑ COMBINATION ❑ BUILDING �MECHANICAL <br />MAIL �OD11E55 <br />�oNtil PX�zAN[cN �f��� H�K&'�Q L-�R�G� �v�T <br />11RCNrtECTOROkS�OMEP M�IL�O�RE55 L�JN���7' � ���� Zin <br />IA�IL epORE54 G�Iv IIP <br />II�ODRE59 Citv ZiP <br />I �D�/� �v7 �V X�E �.1�t1�7'� <br />PLUMBING <br />HONE <br />3s3-3/O <br />❑ SIGN <br />M�II�DORE55 CI1Y p�P�' /'��ij������/��� 4 '�I <br />4UMB�H GONIPAGiOF � (r!J N <br />:L113SOi WORR <br />❑ NEW ❑ ADDITION � ALTERATION ❑ FEPAIR ❑ DEMOLITION ❑ WOODS70VE/FRPL.INSERT ❑ BUILDINO REIOCATION <br />..� ��.nnun[wnPNiCOSf O� M�IERULS PWS LAOOPI <br />DESGRiBE W AK <br />/ L-L �.ti -f'iil2/Cl <br />uec or ewim <br />4 � i <br />�cr_ eiocK— <br />�'.�LUMSlNG <br />4' NO. <br />�. d;rf W�TER <br />� �:tl n. BATHTI <br />URINAL <br />DRINKII <br />FLOOP <br />BACKFI <br />ROOFC <br />0 <br />•IT�CN <br />OF <br />Y (WASN BI151N� <br />SINK 6 U�SP. <br />MER <br />TRAV <br />— R�INlEA0ER5 <br />. — BAR. ETCJ <br />� ��J �N�� <br />SU! TOT11l i <br />PERMIi f <br />TOTALFEE 1 <br />VSE20NE �^^�^� y�C�NT5ITE <br />OYES �NO <br />IYPEOFCON51 OCCUP�NCYGROUP NOAFDWElUNOUNI <br />5{IEOFBLDO NOAFSIORIE9 M�%OCCl0A0 <br />fIRE SPRINKLERS REOUIRED ❑ VES O NO <br />�VPU:4110N�GC 0� PUNSCNECREO6Y �PPR.fO0i55U�NLE <br />I HEREBY CERTIFY TI1AT I HAVE READ AND EXAMINED THIS AP• <br />PLICATION AND KNOW THE SAMt TO BE TRUE AND CORRECT. ALL <br />PROViSiONS OF LAWSAND ORDINANCESGOVERNINGTHISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HE9E• <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TQ VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE C1R LOCAL lAW FEGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. . <br />SIQN�IURE OF GONiR�CIOR ON RU7NOIi1ZE0 AGENT �ATE <br />x �/,� e� • r�-��a,� <br />�PP�IG�NTSLIlYBU51NEi5UCFN5E O <br />oD�9h <br />MECHANICAL <br />NO. TYPE OF EOUIPMENT FEE <br />R/C — A/HNOLO UNITS — H O, <br />REFHIOERATION UNITS — H P. EA. <br />BOILERS — B.T.U.11i P. <br />GAS FIRED �.C. UNITS — B.T.U. <br />FORCED AIH SYSTEMS — B.T.U. / M�� <br />WRLLMEATERS—B.T.U. M <br />UNIT MEAT[RS — O.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DiiYERS I <br />VENTIUTION FAN <br />R�NGEMOOD <br />WATER MEATER : <br />WOOD STOVE <br />METAL FIPEPLACE 6 CHIMNEV <br />4UB TOTAL <br />PLAN CMECN NUMBEF � FEE I RECEIPT NO. <br />BUIl01NG S <br />PLUMBING <br />MECHANICAI <br />OTHER <br />STATE BUI�D�NG SURCI�ARGE <br />STATEENERGVSURCHAFGE <br />PUBLIC WORKS <br />TOTAL <br />PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING ALL <br />PROPLRTV LINE LOCATIONSAND RELA'iE� EASEMENiS. <br />