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,�.t.,o,�„ Ar'P�ICATION FOR <br />��T�oF CONSTRUCTIQN <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259•8B10 TO BE COMPLETED IN INK • PLEASE PRINT <br />O DEMOLITION ❑ COMBINATION l7 BUILDING ❑ MECHANICAL <br />�,...,� �n , n nuu �nnr,is�; .. . _ arv nr <br /><, ; � <br />�' a . <br />everetl <br />e <br />❑ PLUMBING ❑ SIGN <br />•H�.u�lilCtOn s�r.rvi. r.ui� �nnNtS, � / Ynr :tl� N�oNL <br />GINU�4[OYiRAGIC� � n Mu1+011N15 —� =:i11 :iP PI�ON( , IICEN$C• <br />MLCH• +I CONIIUC.IOq - —� � � �I.Uq �pP�iltii � 'r CII� /d' <br />V <br />1'IUMPM�iC�NiH4:lOq A1111 aPPl�l .:, l]�Y l�l' <br />.� <br />❑' NtW L�I ADOITION <br />�l UUIOH Oc WONn �CO51 pl AIAI( <br />/I�� r �� <br />1VORM <br />icc+i ocscnmr��r� or anorc <br />�o�—e�oc�_o�. <br />PLUMBING ' � <br />� <br />lICU1Sk • <br />u <br />� ..� <br />ALTERATION ❑ RGPAIR ❑ OEA1(" I11U�� ❑ �YOODS10VE/FRPL.INSERT ❑ 13UILDWG RELCCATION <br />S PI U:: i u�n�U __—' _— .'—__�'_ <br />W�TER CLOSET �TO!LETI <br />BATHIUB <br />LAVATORV IWASM BIISIN� <br />SMOwEN <br />NITCHEN SINN A O�SP <br />D�SHWASNER _ <br />IAUNDRVTPAY <br />CLOTNES w45MER <br />Up�NAL <br />ORINKING FOUNTA�N <br />fLOOR DRAIN <br />BACKFLON�PREVENTERS <br />ROOF DF�INS - RnINIEAOE <br />SMK �SERVICE - BAN. ETC � <br />� vOq1 5E 1N�fn <br />IONL <br />SiIE O� <br /><r�vi i,::hn'i e( r Ilv <br />` y 1/�� <br />rounr.orrt <br />ITEM � FEE <br />SUB TOTAL f _ <br />PERMIT f <br />TOTAL FEE f <br />RL�RSEtO�Crc SiDFS[lO�Ln <br />l0i anU vACRII S�IL <br />i1rL5 I INO <br />nrflln�lu'Vfnnlln 110 OI pWlll <br />YO O( S10NIC5 <br />,nno <br />:NSiH[LY.[DBv IaPPRiOfli55u�NGtOY <br />I 11ERGBY C[RTIFY THAT I HAVE READ AND EXAMI�JED TH�S AP� <br />PLIC;ATION AND KNOW THE SAME TO BE TRUE ANDCORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING 1'HIS TYPE <br />OF �JORK WILL BG COMPLETED WITH WNETHER SPECIFIED HERE� <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />IiIVE AUTFiORITY TO VIOLATE OR CANCEI THE PROVISIONS OF <br />ANV OTHcR ST�TE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNAIURE j GONI{i<f.iGl AUfI ) EDAGENT p4fE <br />X v�j � ;., ..� �'�—/�/- ��' <br />crru�ar�rs cin' au�n��5s � rtu=t Mn <br />MECHANICAL <br />NO. TVPE OF EOUIPMENT <br />A/C — AiMNOLG UNITS — H P <br />REFRIGERATIONUNITS—HP EP. <br />�OIl.ERS — 0.T U �N P <br />.ASFIREOAC UNITS—BTU <br />FORCED AIR SYST[MSi O T U'% M EA. <br />WALLMEAIE(i5-9TU. M <br />IINIT IIEATEfI$ — 8 T U M <br />GVAPOPATIVE COOLERS <br />CLOTMES DRYERS <br />VENTILATIPN FAN <br />RANGE ��000 <br />WATER HEATER <br />WOOD570VE _ <br />AIETAL fIREPLACE 6 CHIIdNEV <br />FI(7EPLACE INSEfiT <br />MEAT PIIAtP <br />CAS PIPING <br />E%NAUSTFAN <br />� V (� �� SUB TOT�L <br />PERMIT <br />TOTALFEE <br />r'I..�N �:11tCR NUMOEil � FEE <br />rec <br />RECEIPT NO <br />FEES VAlun�iun � rcC_ <br />❑UILOING S "'� <br />PILMBING <br />,� <br />MECHANICAL <br />O7HER <br />STATB �UILDING SURCMARGE <br />STATEENEFGYSUACHARGE <br />PUBLIC WORKS <br />TOTAL �� <br />1'ROPFRTY OWNEf7S ARE fiESPONSIBLE FOR DETERMINING ALL <br />PROPEH7Y LW[ IACATIONS AND RELATED EASEMENTS. <br />