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I�s Everpre�n <br />CIfV OF <br />everett <br />BUILDING DEP�RTMENT <br />259-8810 , <br />,---. <br />ArPLICATION FOk <br />CONSTRUCTION <br />PERMIT <br />TC BE COMPLCTED IN INK • PLEASE PRINT <br />everetl <br />e <br />❑ DEMOLITION L�COMBINATIUN ❑ BUILDING ❑ MECHANICAL ❑ PLUMB�NG ❑ SIGN <br />JWNCF MMLPDDRC55 GIiY SiP VNONC <br />�i;i']:.. � 1� !�j !'� �ll . l . . l� '���rn' J'"�-I — <br />19C��IILl�i091)L!.�Iii1tN IA�ILAOOPE55 GI}Y Z�P PHnNE <br />.T. ! Yn�4 <br />i.! NCHAL fOYIF1ClOA IA11L aDI1NE5S G'��� LIP °MONC LiLElISL � <br />:�ti <;' Gr::�-.-� i 3; �'� <br />__ _ ...�� .,.���..� arv ziv r�norv4 ucv�s[. <br />vWNBINGC�)N1RiC10F M�IIApDNESS CIl\ !i✓ r�Wrv[ ti�trmc. <br />�- � 1 �i..� �.� -Iv%� �%a� �;a-�f,: ��; <br />� �.� ,� <br />GU55 � V/OP✓. <br />'�NEW ❑ ACDITION ❑ AL7ERA7ION ❑ REPAIR ❑ DEMOLITION ❑ WOODS70VE/PRPL.IN5EP7 ❑ BUILDING RELOC�i10N <br />�:n�unrov or wene ico;r or �an*oaa�5 �ws taonei <br />[1l5CRIOL <br />lV )��.� /l�t; <br />usf Of <br />��i Or.11c'i? <br />L[Gnl OESCFIPLON O� PAO�EPiv�SMOWN 0[lOW ON PITAC��lOU� <br />io, L—� dioc.._or 7. C. <br />I'uOJECf ADOFES. <br />/D <br />PLUMBING <br />Ip, TYPE OF FIXTURE <br />Z W�TEN CLOSET �TOI�ET� <br />� pA1MTU0 <br />�AVATORYIWPSHBASIN� <br />/ SHOwER <br />KITCHEN SINN .l OISP <br />1 �ISHWASHER <br />LnUNDFYiRAY <br />/ CLOTMES W 1SHER <br />UA�NAL <br />ORINHING FOUNTAIN <br />FLOOR OFAIN <br />ROOF DRPINS — � <br />SINK ISERVICE — <br />�.i r�r yrrp<i n <br />� L� , <br />��i zonc <br />�— � <br />�.rE or covsr <br />V—N <br />�Ifal= SPRINKLERS <br />�n <br />IAR. ETC 1 <br />SUBTOTAL <br />PEPMIT <br />TOTnLfEE <br />REGq $C19PCN <br />7�� � <br />i Oi aFE4 <br />`70 �n <br />..tyii.::.�ii:"yp[-. pv IPLANSCMELKEDBY <br />� ' <br />� ACANi SIiE <br />..vES �NO <br />Ho or owrwvc <br />/ <br />rnna occ wAo <br />/i�� <br />I HER[BY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP� <br />PLICATION APID KNOW THE SAME TO BE TRUE AND CORRECT. ALl <br />PROVISIONSOF LAWSAND ORDINANCESGOVERNINGTHISTVPE <br />OF WOf K WILL BE COMPLETED WITH WHETHER SPECIFIED HERE <br />IN OF NOT. THE GRANTING OF A PERMITDOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATC- OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CON57RUC?ION <br />OR THE PERFORMANC'c OF CONSTRUCTION. <br />SIGNaiURLO�CONfRACTGROf1AU1NOR�:f[IaGCNT �niC <br />X ��1�1� • '/�/��' <br />an��iCnrir;,arrtt'.n�Nts�i�ctqst�u� �� <br />MECHANICAL <br />TYPE OF EOUIPMENT <br />ArG — ArHN�LG UNI75 — M P <br />FEFRIGEPATIpN UNITS — H P EA <br />BOILERS—OTV�MP <br />GA$ FIFED A C. UNIT$ — B T U <br />�ORCE� AIR $YSTEM$ — B T U M EA <br />\YALL ME�1T[RS — � TL. M <br />UNIT HEATERS — B T U. M <br />EVAPO(iATIVE COOLER$ <br />CIOTHES DflYEf�S <br />VENTILATION FAN <br />PANGE��OOD <br />WATER 1'EATER <br />WOOD S7oVE <br />MEfAL G7dCebA665 CHIMNEV <br />fIREPLACEInSERT <br />MEATFUMP <br />GA$ PIPING <br />E�NAUSTfAN <br />SUBTOTAI <br />PERMIT <br />TOT�LFEE <br />PI.AN CMECN NUMBER � FF.E <br />FEES <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />$TATE �UIIOING SUACNAAG <br />STATEFNERGYSURCHARGE <br />o� <br />PUBLIC WORKS <br />TOTAL <br />$ <br />RECEIPT NO. <br />FEE <br />PROPERTV OWNERS ARE R[SPONSIBLG =0R LFTERMINWG ALL <br />PROPERTY LINE LOCATIONS AND REIATED EASEI.�ENiS. <br />