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,. , , . . , , . .. <br />. _ � , . : , ,. ,... , . . <br />- ,•-:, <br />r:�'PLICATION FOI.��' <br />'"'E»'°'"" CONSTRUCTION <br />cm oF <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK- FLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING �MECHANICAL ❑ PLUMBING <br />OWNEfl M�ILApORE55 CIiY 21P PNONE <br />Scor�- v✓�c.r��. ��2� R�-iui� Av EvT 92�0/ as�S �� <br />_. __ ..... .nnncee f rv 21P I IIONC <br />COY <br />X/E d42L � <br />C�fY W � <br />C�IY <br />{3s - <br />('110NE <br />❑ SIGN , <br />, _ ; <br />I <br />ILEN� ' <br />IGENSE • <br />ICENSE � <br />� <br />O"NEWV^�AD�ITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING PELOCATION <br />V�IUATION OF W08N �COST Of hlRl[qI�LS PWS LROOflI . <br />/xlST�k L� <br />USE OF BUiLOiNGD <br />, s � """ <br />IEG�L DESCRIPTION OF PP <br />s ►n/�}LL ff�4T� <br />no�e/c� ewneaa <br />i(oo� � �i��� �v� <br />PLUMSIN6 <br />NO. T/PE OF fl1fTURE OR ITEM <br />W�TER CI.OSET �TOIIET� <br />BATHTUB <br />UVATORV IWASFI BASIN� <br />SNOwER <br />1(ITCMEN SINN 8 DISP. <br />[71SNWASHEF <br />UUNORYTR�Y _ __ <br />URINAL <br />OIINKING FOUNT <br />FLOOR DRAIN <br />BACKFLOw PREVI <br />ROOF DRAINS —! <br />SINK �SERVICE — <br />IRpNiSEi6�CN <br />USE20NE <br />ttP[ OF CONSi <br />size or eioe <br />FIRE SPRINKLER; <br />-0PPI ILAIION ACf. OV <br />0 <br />TOTAL <br />tf--��15 ln/�}TE.�. ��-T��- <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• ,. <br />PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL � <br />PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE i <br />OF WORK WILL BECOIvIPLETED WITH WHETHERSPECIFIED HERE• <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO ` <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF' f <br />ANYOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTION j <br />OR THE PERFORMANCE OF CONSTRUCTION. . ' <br />SIGNAT RE OF CONIR4CTOA OR AUi110RIZFD AGENT IIATE � <br />X,��Jdfij, � <br />•PPLIGNI'SGItY9U5iNE55LiCEN END � <br />DU�t�� <br />MECHANICAL <br />FEE NO. TYPE OF EOUIPMENT <br />A/C — A/MN�LO UNITS — MP. <br />HEFHIGERATION UNITS — H P EA. <br />901LEP5 — B.T ll./H P <br />GAS FIRED A Q UNITS — B.T.U. <br />FOliCED AIR SYSTEMS — B T U. M <br />WALLHEATERS—BS.U. M <br />4NIT HEATERS — B T.U. M <br />EVAPORATIVE COOLEFS <br />CLOTHESORVERS <br />VENTILATION FAN <br />qANGEHOOD <br />WATER MEATER <br />WOODSiOVE <br />MEfAL FIREPLACE 6 CMIMNEY <br />FIREPIACE INSERT <br />MEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />s SUBTOTAL <br />= PCRMI� <br />f TOTALFEE <br />.,,� ��.o.,,,, ' j PLAN CNECK NUMBER I FEE I NECEIPT NO. <br />LOTARE� y/,��NTSIiE <br />OYES ONO <br />OCCl1PANCY GROUP NO OF DWEI <br />�ono <br />BY �APPB FOf1155uANCE9Y <br />BUILDING 5 <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STA7E BUIIOING SURCMARGE <br />STATEENERGYSURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />PROPERN OWNEiiS ARE RESPONSIBIE FOR DETERMINING ALL <br />PROPERTY LINE LOCATIONS AND RELA'iED EASEMENTS. <br />