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rn. enryr..� <br />cin oF <br />everett <br />BUILDING DEPARTMENT <br />259•8810 <br />i��'PLICATION FOI.-� <br />CONSTRUCTION <br />PERMIT <br />TO BE COMPLET�D IN INK- PLEASE PRINT <br />everetl <br />� <br />. ❑ DEMOUT�ON ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ �LUMBING ❑ SIGN <br />OWNER M�IL�OORE55 CIIV Zi� PMONE <br />Grc�n���u /9�y �J .�Y3otSr.ri 9Sro3 5�/dEz�� — — <br />- AFGNIfGCTOAUk51GNER MeR4DDNE55 CIY I P ONC <br />11 <br />, 4lNEP�LCONIa�GiOR MI.IL��UPE55 C1�V I�P �IIONF LILENS[• <br />1� <br />�ee,l�i i�3�L <br />. MEGN�NIC�LCONiR�LiOq M�IL���RE55 GIIY Ilt� {'110NE ULENSE• <br />VWMOINGCONiR�C10R MAaeDDUE55 Clrv 2u� ��IONE LIGENSE• <br />P� �'V3-`!S>� i�i,�(i[TS�r�«,�. <br />CL�S$ Of WOAh <br />�, NEW ❑ �DOI710N ❑ ALTERAT�ON ❑ F7EPAIR ❑ OGAIOLITION ❑ WOODSTOVE/FRPI.INSERT ❑ BUILDING RELOCATION <br />vnw+rion or woaK icosi oc nuu nu�s rws unom <br />SS mn7 /Zf✓7- ��m.i�. <br />DESC�iBE WORN <br />i(on�c- ('m�51• <br />or <br />�oi� <br />; lDqi <br />PLUMBING <br />: T_ <br />L <br />OR <br />WATER CLOSET �TOIIET� <br />BATHTUB <br />� Z 6AVATORY 1�.'ASH BASIN� <br />I� y SHOWER <br />' KITCIIEN $INN 8'IISP <br />' OISMWASMEII <br />LAUNORYTRAY <br />� CLOTHES WASHER <br />� UNINAL <br />ORINKING FOUNTAIN <br />FLOQR �RAIN <br />� BACNfLOW PREVENTERS <br />� <br />�. raor+rseio:cK-- -- <br />�D <br />usc.or+e <br />2-� <br />• IYPE Oi C� /NSf n/ <br />V _' V <br />SiZEOFHLOG �Z�z <br />�-B S� <br />' FIRE SPRINKLERS F <br />I4VFlIGAIIGN PCC (3Y <br />f <br />— 6AP`ETC.1 <br />�1tAC�� <br />SUBTOTAL S <br />PERMIT f <br />TOTAIfEE f <br />RETR SEIB�GK <br />/ <br />Zc• <br />IOfAREA <br />� z�G� <br />OCCUPRNLVGROUP <br />R�. <br />FEE <br />SIOE SEiOnCK <br />� / <br />\'Af,ANi SIIE <br />❑YkC ❑NO <br />NO OF OIVFLlINO UNIfS <br />PLANSCNECnCO OV APfN fORI550ANCE <br />/ � � <br />i <br />`vGr,:z��,; , .. .'.;;'.L.�.�: . <br />I HERC-BY CERTIFV THA7 I HAVE READ AND EXAMINED TIi15 AP� <br />PLICATION AND KNOW THE SAM17E TO BE TRUE ANDCORRECT. ALL <br />PROVISIONSOF LAWSANDOR�INANCESGOVERNINGTHISiYPE <br />OF WORK WILL BE COMPLETED WITH Wf1ETHER SPECIFIED HERE• <br />IN OR NOT. THF GRANTING OF � PERMITpOES NOT PRESUME TO <br />GIVE AUT� �)RITY TO VIOLATE OR CANCEL THE PROVIS�ONS OF <br />�NVOTV. �'ST�TEORLOCALLAWNEGULATINGCONSTRUCTION <br />OR THE .- �FORMANCE OF CONSTRUCTION. . <br />SIGNAIUPEOfCONtRnCtORORAUt110PIZEDRG[Nf DAtE <br />X 1�/�dl� <br />MECHANICAL <br />�rC - A�HNOLG UNITS - M P <br />REFRIGERATION UNITS - H P. EA. <br />BOILERS - BS U.�H P <br />G�5 FIRED A C. UNIT$ - D T.U. <br />PORCED AIR SVSTEMS -�.T.U. M <br />WALL MEATERS - B T U. M <br />UNIT HEATE(15 - D.T.0 M <br />EVnPO�ATIVE COOlERS <br />CLOTIiES �RYERS <br />VENTIL/1TION FAN <br />RANGENOOD <br />WHTER NEA?ER <br />WOODSTOVE <br />METAL FlREPLACE 3 C�iIMNEV <br />FIREPLACEINSERT <br />MEATPUMP <br />CAS PIPING <br />E%NAUSTFAN <br />SUB TOTAL <br />PEHMIT <br />TOTALFEE <br />PLANCMECNNUMCFp �FEE <br />DUILOING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STAiE BUILDING SURCMARG <br />STATEENERG�SURCHARGE <br />PUdLIC WORHS <br />TOTAL <br />1 <br />RECEIPT <br />PROPEf7TY OWNERS ARE RESPONSIBLE FOR DETERMItlING ALl <br />PROPERTY LINE LOCATIONS ANO RELATED EASEMENTS. <br />.. . ........-., ......... ...... _ . ._. . _._...... .... _.. .__.. <br />�•.. �.:� ....,.. . .. .� . , .. ��� - . . .•. .� .....,.,,- _.. <br />