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'"�' PLICATION FOR`� <br />`��""E"'°"'" CONSTRUCTION <br />,:,,�a <br />= everett PERMiT <br />BUILDINCi DEPARTMENT TO BE COMPLETED IN INK- PLEASE PRINT <br />259•8810 <br />� ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING �MECHANICAL <br />❑ PLI�MBING <br />���,�n <br />e� <br />O SIGN <br />�� <br />GENEMLGONiR�GIDN MML�DDRf55 Gin' IiP o�rONE LICENSE� <br />MEGXIIMGLCONt TOq MML��O 55� ��/^ ���Tv� __ / Z��/�� �//���.� j���I <br />GoZ�/ ���r-/ ��i�6�15 �l Y i� c1L.L r il 1� li <br />7.LJ � �i 7 <br />PLUMBiNG ONTN�GtOR . M�IL �DOAE55 CITY I P P ONE L CENSE <br />cozyH-o �i 3 � � c� <br />GlABS Oi WORY. <br />❑ NEW ❑ ADDITION � ALTERATION ❑ FEPAIR ❑ DEMOLITION ❑ 1NOODSTOVE/FRPL.�NSERT ❑ BUILDING RELOCAtION <br />VAIU�TIONOFWORNiGO510FMAiEfi1�L5PLU5L�BORI ' <br />. / _ <br />:!'/�r-� �L�c'. <br />�,N�L� ��i� <br />� <br />rLUMSINO <br />w�TYP! <br />KITCHEN SINK 6 DISP. <br />DISMWASMER <br />LAUNDRYTR�V <br />C'_OTHES WASHER <br />URINAL <br />DRINKINO FOUNTAIN <br />FLOOR �NAIN <br />OACKROW PREVENtI <br />ROOf DP�INS — AAIN <br />SINK ISERV�CE — B�R <br />i FRONTSEIB�LN <br />� USE20NE <br />j TYPE Oi GONSi <br />j 512EOFBLDG <br />f <br />i <br />FIRE SPRINK�ER'� <br />, �PP�i�Af10NeLC BY <br />1 <br />6UlTOT�L <br />PERMIT <br />TOTAL r[! <br />NO O� SiORiES <br />�L <br />V�CANT SiiL <br />❑�ES ONO <br />�PPR fOF <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />PLICATION AND KNOW THE SAMETO BE TRUEANDCORRECT. ALL <br />PROVISIONS OF LAWSAN� ORDINANCES 60VERNING THISTYPE <br />7F WORK WILL BECOMPLE'ti.D WITH WHETIiLRSPECIFIED HERE• <br />IW OR NOT. THE GRANTING OF .o pERM1T DC[S NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANV OTHER STATE OR LOCAL LAW REGUTATING CONSTRUCTION <br />OR THE PERFORMANCE OF CUNSTRUCTION. <br />516N�IURE OF CONiRRCTOR OR RUTNORI2ED �GENT I1�TE <br />X <br />�-(/ DD(, �t�� <br />MECHANICAI <br />FEE NO. TYPE Oi <br />LOAD <br />AiC — �/MNOLG UNITS — H P. <br />REFRIGER�TION UNITS — MP. EA. <br />BOIlERS — 0 T.U.MP. <br />GAS FIPED A.C. UNITS — B.T.U. <br />FORCED ��N SYSTEMS — B.T.U. <br />WAIL HEATERS — B.T.U. <br />UNIT HEATERS — B.T.U. <br />EVAPOR�TIVE COOIERS <br />CLOTMESORYERS <br />VENTILATI( �N FAN <br />WOODSTOVE <br />MEiAL FIREVUCE <br />FIRE%ACE INSERI <br />MEATPUMP <br />GRS PIPING <br />E%NAUSTFAN <br />.•n CMECK NUMBER <br />SUlTO7Al <br />PERMIT <br />TOTALFEE <br />IFEE <br />M <br />M <br />FECEIPt NO. <br />FEES VALUw��vn rcc <br />BUILDING 5 <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BUILDING SURCHARGE <br />S7ATEENERGYSURCHANGE <br />PUBL�C WORKS <br />TOTAL <br />PROPERN OWNERS ARE RESPONSIBLE FOR DETERMINING ALL <br />PROPERN LiNE LOCATIONSAND RELATED EASEMENTS <br />r;.:n-1 . .,. .. . � ' _ �. . ... ,. . .. . ,. ._ � � .. . . - � .� �. � . . .. � .. . .� . <br />