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�E~ro� t CONSTRUCTION�� <br />an or <br />everett � PERMIT <br />BUILDING DEPARTMENT <br />259•ai45 TO BE COMPLETED IN INK • PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILD�NG ❑ MECHANICAL <br />❑ PLUMBING <br />❑ SIGN <br />4tNEP�LCON�N1LfOR MsiI��GRE55 CITV 21P PNONE LICENSE• <br />�vx �p��F, �,iT',,:'1 .J���i TSt/� /�h.�a -/�G-yJ�ayls;//e y.P�y�) 654-/�Zi) <br />MkbuNiULCONIRFCiOq AIIL�DORC55 CI1V IIP PNONE IICENSt• <br />C.Ua,'CL��t�1(rQ1/9 <br />FWMBIN6CUHIR�CIOq M�I��O�RE55 CITY ZIP PIIONE UC6NSC • <br />C1�550f WORrc <br />❑ NEW ❑ A�DI�ION ❑ ALTERATIOt1 ❑ pEPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSEtiT ❑ BUILDING FELOCATION <br />V�LU���ON OF WOPN�COSI Of M�IC��ALS PLUS L�B01ry � <br />Ilf NI9! WORR P <br />�� � � � _ m��it l ' ,a�1 ��r <br />usr �eu oi c <br />�<<,. �„���.Q <br />t CGeI OESCRiPfiON OF PpO�ERI V IS�IO W N OEIOW OR • <br />� oi_ owc�_ or <br />SINK <br />TR�V <br />V41:IIIIM I�I1f�N1 I�!: <br />� <br />PERMIT <br />c . - <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />PLICATION AND KNOW THE SAME TO RETRUE ANOCORREC7. ALl <br />PROVISIONS C� LAWSAND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL 8E COMPLETED WITH WHETHER SPECIFIED HERE• <br />IN OR NOT. THE GRANTING OFA PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE ONiRpCTOROR �10R12fDAGENt OtTF <br />X / / / Ci_1''� �/ <br />ION UNITS—H.P. EA. <br />P. ER. <br />L. UNITS—TONNAGE E/ <br />SVSTEMS—B.1.U. M EP <br />RS—B.T.U. M <br />�S—B.T.LL M <br />:COOLERS <br />VERS <br />FAN <br />) <br />G UNIT— GF.M. <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />RUq5E1PAGN SIOE3ETB�CI( PLANCIIECBNUMBER PUNnuGK <br />•d IUN[ <br />��'COf CONSi <br />V! Or p�DG <br />IRE SPqINKLER: <br />�'�9�Ce11UN�Cf, Ilv <br />OCCl1PRNCVGROUi <br />n <br />V�C�Nf SIIE <br />[]YES ONO <br />OCG.l0�0 <br />fOR ISSU�NCE 6Y <br />BUILOING <br />PLUMBIN6 <br />MECHANICAL <br />OTHER <br />PEN��iY <br />TOT�L <br />FEE9 <br />fCE lIEC[IPiNO <br />V�lU�T10N FEE <br />f <br />