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M� EwrorMn <br />Cin or <br />everett <br />BUILDINO DEPARTMENT <br />259•8810 <br />r CONSTRUCTION� <br />PERMIT <br />TO BE COMPLETED IN INK- PLEASE PRINT <br />O DEMOLITION O COMBINATION ❑ BUILDINQ ❑ MECHANICAL ❑ PLUMBIN6 ❑ SIGN <br />M�i��ooaeee utv zir v�wr+c <br />OWHE11 <br />�_.._.. s...:.3"� i3i9 �f33.vKerL�.0 ave. �� 9?�e3 .3f�$-�/S .Z <br />6t��EP�I LOHIN�GIOP M�IL A�ORE55 CIIY ZI� M�ONE Uf.fNSf • <br />-- c.�-_•s �r�_.-�.e fi!%/2�07_ <br />PNOHE <br />NSE • <br />iIUMlINOCONTR�GIOII MML�DORE55 LI�Y 2iP P��ONE UCFNSt• <br />C:�SS O� M�OR6 <br />❑ NEW ����TION ❑ ALTERATION ❑ REPAIP ❑ DEMOLITION ❑ N�OODSTOVE/FRPL.INSERT BUILDIN6 RELOCATIC�J_ <br />VALWTIOMO� WOAv�COlt Oi M.11lI11�L4�W�L�BORI <br />t��..n.r��' � G/l'� �� <br />r7/cc lc j - <br />101EC11DORE55 <br />.5.9�ir1 e <br />PLUMlIN6 <br />Mp, TYP[ OF F11ITU <br />WATEN CLOSET ITOIIETI <br />B�TMTUB <br />UVATOPY �WASM BIISIN) <br />SMOWER <br />MITCMEN SINK t O�SP. <br />{niIN11L <br />DA�NKING F <br />FLOOA ON� <br />BACKFLOW <br />ROOF OAAI <br />SINN �SERV <br />— BRR`ETCJ <br />7USTOT�L <br />PERMIT <br />tOilll iEE <br />�AONISEIB�CM �EAR SE�B�CR <br />zo ' Z ' <br />0 <br />USE20NE LO��AE� <br />�� � <br />rvPE0�Sj1M=t'/ Of,CUV�i� GF� <br />V� /V P <br />S4E 0� 01 DG n0 OF S�OPIES <br />d/G S� I <br />iorucc er <br />� 4� <br />Pr���� <br />L�. } �o� <br />V�C�Ni S�TE <br />OYES '�NO <br />NO OF OWFLLINO UN <br />MAR.OLG L� <br />N� <br />IEGNEDBV I���RFORISSO�NCEBY <br /><'� �; <br />1.3r2..� <br />I HEREBY CERTIFY THAT I HAVE READ AND tXAMINED TIIIS Ai`� <br />PLICATIONAND KNOW THE SAMETO BE TRUEANUCOPRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNIN6 THIS TVPE <br />OF WORK WILL BECOMPLETED WITH WHETHEFi SPECIFIED HERE� <br />IN OR NOT. THE GRANTING OF A PERMITDOES NOT PRFSUME TO <br />CaIVE AUTHORITV 10 VIOLATE OR CANCEL THE PROVISIOPIS OF <br />ANYOTIIER STATE OR LOCAI LAW RE6ULATINGCONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION, b—FS� <br />SIONATURE OF CONIR�CTOR OR AUTHORI2EO �6ENT Il�7E y�� <br />X�5:��-���� <br />�«<� <br />ACPIIC�NTS CITY BUSINESS IIGENSE NO <br />MECHANICAL <br />NO. TYPE OF EGUIVMENT <br />�p — /VMNOL6 UNIT9 — H.P. <br />necnvaFN�TION UNITS — M P. EA. <br />BOIILhJ — O.1.V.In.r. <br />UAS FIRED A.G. UNITS — B.T.U. <br />FORCED I11R SYSTEM9 — B.T.U. M FJ�. <br />WALLMEATEHS—B.T.U. M <br />UNITHEATEPS—B.T.U. M <br />EVAPOR�TIVE COOLERS <br />CLOTHESOAYERS <br />VENTIUTION FAN <br />MNOE NOOD <br />WATER MEATER <br />WOO�STOVE <br />, METIIL FIREPIACE 6 CMIMNEY <br />FIREPIACE INSERT <br />HEATPUMP <br />OAS PIPINO <br />EXHAUSTFAN <br />!UO TOTAL <br />PLAN CMECN <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BU�LOING <br />� I FEE I AECEIP� <br />N0�5 y c <br />STATEENERGYSUACHARGE <br />PUBLIC WORKS <br />TOTAI I � �' ' <br />PROPER VONELOCATIONSANDNRELAIEDEASEMENTS!N�AIL <br />