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,-. ^ <br />H�PLICATION FOh <br />'"'E"'°'"" CONSTRUCTION <br />GI'I OF <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259•8810 TO BE COMPLETED IN INK - PLEASE PRINT <br />❑ DEMOLITION ❑ COMB�NATION ❑ BUILDING ❑ MECHANICAL <br />JWNf. JrPI/{� JV}-` _ AIA( � _��CS."./L/L i�� M�r.l /__ •�/ ` V�Z I <br />�.%wv 1 1 lVii�KiV ��VYV r �K V <br />A141L <br />MPII <br />nuii <br />MA1l <br />cnr <br />❑ PLUMBING ❑ SIGN <br />P��`�9(no I li <br />ci,� ri�� l.Y�l G�GO��V.T�i+'[��4 <br />CI�Y '^ ' IIP 1'110NC ll[ENCf • <br />�' �V.�� <br />Citv 11V` i�IIONE LII.C�IlE • <br />� NEW ❑ ADDIiION ❑ ALTERATION ❑ REPAIR ❑ DEMOLiiION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION <br />V�L�IONJ�WORMICOSiOf1A4iC�laL5PLU5LAE0Hi (yy�'j�tdf./j7c -. "'' <br />HO Z(o0 c3� r'-. : �� <br />/ <br />nocrowcwnnn _ • '_ • /'1 _ _ _ 1 . <br />USE Of BU�I��Nti <br />Sl►'�lR. �o�t�� <br />LEG�L DESCRiPi�ON OF PROPERiY ISNOW N BEl( <br />101� BLOGI(�� OF <br />� ���` <br />vpOJECTspORE55 <br />�-✓'LI O�mpic <br />PLUMlING <br />NO. TYPE OF FI%TURE OR <br />WATER CLOSET ITOILETI <br />BATHTUO <br />LAVATORY IN'�SM BASINI <br />SHOWER <br />ICITCHEN SINK 8 OISP <br />OISNW�SMEF <br />LAUNDRVTRAV <br />CLOTHES wASMER <br />UPINAL <br />DRINKING FOUNTAIN <br />FLOOR ORAIN <br />BACKf:CW PREVENTERS <br />ROOF ORAINS — HAINLEADE <br />SINK ISERVIGE — BAA. ETC � <br />�RONiSEiP�Ch <br />� <br />usE zur�E <br />� ��1 <br />ivV[ Of CO�_$i <br />1-N <br />SiZE OP OIOG <br />22zS <br />n�•o��,.nnorv rrc ar <br />� �� <br />sueror�� <br />PERMIT <br />TOTAIFEE <br />AIPR SEIBACh <br />A � <br />LOi PRU <br />I �. <br />HO OF 5'00.iE5 <br />Z- <br />FLII <br />� � <br />cNecnm er <br />.-...t.� �— y 1 <br />fEE <br />I I�EREBY CERTIFY THAT 1 HAVE READ AND ExAMINED Tf11S AP- <br />PIICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PRGVISIONS OF LAWSAND ORDINANCESC�OVERNING THISTYPE <br />OF WORK WIL� BECOMPLETED WITH WHETHERSPECIFIED HER6 <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEI THE PROVISIGNS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFOf7MANCE OF CONSTRUCTION. <br />SIGNaIU�fl O� CONiR>CiGR OR AUTMORiZ[0 aGENT D4i[ <br />X J�� 8 � i �8v <br />AOPLILANiSCI�V pU51NL55Uf,LNSE 40 <br />MECHANICAL <br />A�C — AiMNDLG UNITS — N P <br />REFRIGERATIONUNITS—NP EA. <br />601LER5 — B TL iH P <br />GAS FIRED A C. UNITS — B.T.0 <br />FCRCED AIR SYSTEMS — B T.U. M EA. <br />WALLNEATERS—BS.0 M <br />UNIT HEATERS — 8.T l;. M <br />EVAPORATIVE COOLERS <br />CLO1'HESDflYERS <br />VENTILAiION FAN <br />qANGEN000 <br />WATER HEATEH <br />\YOOD STOVE <br />fdETAL FIREPLACE 6 CHIMNEV <br />FIRFP:AC[ INSERT <br />HEAT Pl1MP ` <br />GAS PIPING _ <br />E%HAUSTFAN <br />s _ SUB TOTAI <br />t PlHMIT ' <br />� � � TOTAL FEE l <br />S�DE SEiBeCN PLAN CME NUMBER FEE (�`� NECEIPT NO. <br />� � ;���J�,�f ( `�� ���? l ���c <br />vncnN*sin FEES VAlUAT10N FEE <br />ES ONO <br />BU�LDING 5 �O �:� <br />NO Of �WRU4G UNITS <br />' PLUMBING <br />MnN OCC �Oa� MECHANICAL <br />oTHen <br />STATE BUILDING SURCHAFGE � <br />STATEENERGYSUFCHARGE � <br />nvva ron issuAr+ce er I <br />PUBLIC WORNS �,7 <br />� � l TOTAL <br />l-�,� <br />PROPERTV OWNERS ARE RESPONSIBLE FOR DETERMINING ALL <br />PROPERTY LINE LOCATIONS AND RELA7ED EASEMENTS. <br />