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7�tPPLICAR 10 TION� <br />GE�'"" CONST U <br />everett PERMIT <br />BUILDING DEPARTMENT TO BE COMPLETED IN INK • PLEASE PRINT <br />259•8810 <br />_ _....... ���.,.� n eniuwlNATION Ii�BUILDING ❑ MECHANICAL <br />❑ PLUMBING <br />❑ SIGN <br />FLUMBINOCONTR�GiON , <br />M�IL�OORE55 CiTY 2iP ���ONE LICENSE• <br />{ OF WOpK <br />NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVEIFRPI.INSERT B111L�ING RELOCATION <br />�TiONOFWONN�COSTOFM�1ERUtSPLUSL�90R1 � <br />. .__ an i�i�i�i/iIl_ —__ <br />�oi � <br />n�u� <br />IfITCMEN 91NK � DISP. <br />URINAL <br />DRINKI! <br />FLOO(1 <br />BACKR <br />ROOFC <br />SINK IS <br />— BAR, <br />— susror�i <br />PlRMIT <br />TOTALFEE <br />B�Cn RE�RSEIB�GK <br />�o' �o' <br />LOT�RE� <br />-� 928s <br />�NST OCCUP�NCYGPO <br />r A/ R".� <br />.v <br />pp NO.Oi510RIE9 <br />I�H,e I <br />G' <br />V�C�NT SIIE <br />ovES oN0 <br />N.A� <br />;4IION�CG BY PLOASCNELNEOBY IMPF FOPISSU�NGE <br />� � L, G <br />� <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED TMIS AP• <br />PLICATION AND KNOW THE SAME TO BETRUE ANDCORRECT, ALL <br />PROVISIONSOF LAWSAND ORDINANCESGOVERNINGTHISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />�ORITY�IOLATE OF CANCEL THE PROVISIONS OF <br />A THEfi STAT O OCAL LAW REGULATING CONSTRUCTION <br />O T ERFOR OF CONSTRUCTION. . <br />nr. nio CnaTM ❑THORI2EOAGENT DATE <br />X <br />MECHANICAL <br />No. Trve oF ec <br />AiC — �/MNOLG UNITS — <br />REFRIGERATION UNIT$ — <br />BOILEPS — B.T.0 /H.P. <br />O�S FIRED A.C. UNITS —1 <br />FONCEO �IR BVSTEMS —' <br />WAIL HEATERS — B.T.U. <br />UNIT MFATEFS — B.T.U. <br />EVAPORA7IVE COOLERS <br />CLOTHESDRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />w000 STOVE <br />Mt'TAL FIREFUCE 6 CHII <br />v�RFPIACE INSERT <br />OA$ <br />lAN CHECN NUMBEH <br />S� 7 �l �5 �S <br />� <br />M E11. <br />M <br />M <br />5UlTOTAL — <br />vc�wr � <br />TOT11L FEE 1 � <br />RECEIPT NO. <br />FEE <br />�.�a � gos6� <br />BUILDING � `t' � <br />PLUMBING , � <br />MECHANICAL S <br />OTHER <br />STATE BUILDING SURCHAPGE <br />STATEENEPG�SURCHARGE <br />PUBLIC IYORKS <br />TOTAL <br />PROPEFTY L�INE L CATIONS ANDNRELATED EASEMENTS NG ALL <br />I - <br />� <br />