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t.PPLICATION FOI� <br />�n�Ewrpm� CONSTRUCTION <br />Cltt OF <br />everett PERMIT <br />BUILDINGDEPARTMENT TO BE COMPLETED IN INK- PLEASE PRINT <br />259•8810 <br />❑ pF_MOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL <br />21P <br />pWNEN <br />MR� <br />M��. �ODRE55 ��TM <br />i <br />/� /`�l�zL PS �'S �7 ,�'r�L� J�.r/� �=, t"�.ey�— <br />MIIL ADO�E55 �11V � P <br />�l/c G Lro`- <br />•vuneoa <br />everetl <br />e <br />❑ PLUML�NG ❑ SIGN <br />�"�Ey_ S[ ai 'f <br />•�s5'- zz34• <br />CNONE <br />C-/ d'- .?�7 Z <br />VHONE UGENSE• <br />�'aHN�i E/3��; <br />P��ONE LiCENSE � <br />��' �fN� � '�I? l � � <br />m�nuc LI[EHSE • <br />CL�55 O� H'OAK <br />❑ NEW ❑ ADDIiION ❑ ALTERATION �7EPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPLINSERT ❑ BUILDING RELOCATION I <br />vuu.iioN or wan. �cos� o� M�t[nints rtus i�eo�i I� <br />�'U Q r U � <br />�eae� ocscplP110N� <br />� �m�6LOLn�- <br />PROJECT�pOR[55 <br />SS U % iw <br />PLUMBING <br />NO. TYPE OF FIXTUN <br />WATER CLOSET �TOILETI <br />BATHTUB <br />UVATORY �WASH B�SIN� <br />SMOWER <br />NITCHEN SINK 6 DISP. <br />DISHW�SHER <br />LAUNDRY TRI1V <br />CLOTHES WASHER <br />URINAL <br />ORINNING FOUNTAIN <br />FLOOP DRAIN <br />BaCKFIOW PREVENTERS <br />ROOf DRAIN$ — FA�NLEAC <br />SINN �SERVICE — BnR. ETC <br />{ROM SE�U�CM <br />ZO l <br />USErI'�ONE <br />Y_ % <br />-N <br />� S F. <br />NPPIIl;F11pNnCf, pv <br />� � - <br />vu <br />ITEM <br />SUSTO�AI <br />PEpM1T <br />TOTAIFEE <br />� � C����t, :��•���� �i <br />I HER[BY CERTIFY THAT I HAVE FEAD AND E%AMINED THIS AP� '', <br />PLICATIONANDKNOWTHESAMETOBETRUEANDCOP.FECT.ALL ��, <br />PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE I <br />OF WORK WIIL BE COMPLETE� WITH WHETHER SPECIF�ED HERE- <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO I <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANYOTHER STATE OR LOCAL LAW REGULATINGCONSTRUCTION i <br />OR THE PERFORMANCE OF CONSTRUCTION. . ' <br />SiGNAlU7� CON R4Q0�0� UT ORIZE /GENT OA7E <br />X • �,u v�. � 2 2 - ��- <br />inruc rscrtv ousmt ' ucH�S �i <br />MECHANICAL <br />FEE NO. TYVE OF EOUIPMENT <br />A/C — �/MNDLG UNITS — HP. <br />REfRIGERATION UNITS —H.P. EA. <br />OOILER$ — B.T U M P. <br />GAS FIRED AA. UNITS — 8 T U. <br />FORCEDaiASYSTEM$—BS.U. MEA. <br />WAI.L HEATERS — B T.U. M <br />UNIT HE�TEi75 — O.T.0 M <br />EVAPORATIVE COOLERS <br />CLOTHES DAYERS <br />VENTILATION FAN -- <br />RANCENOOD <br />WATEP 11EATER <br />WOODSTOVE <br />METAI FlNEPLACE 8 CHIMNEV <br />FIHEPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />F%MAl15T FAN <br />95E1BACR �mtaunnv. <br />Z� J`� <br />AAEA r VRCFNISIfE <br />�9! �� �'.1_. ❑vE5 0 <br />b <br />UP�NGYGPOUP NOOFpWEI�NG <br />�P-3 <br />Of STOPiES MAN OCG LON� <br />� �� <br />IECN� (PPPR �OI115Sp�NLEOV <br />/� <br />FEE <br />1 <br />SUBTOT�I ti <br />P[pM1T <br />TOTALFEE <br />VLAN CMECN NUMBEA FEE O RECEIPT NO. <br />Sg lqy�c� �I �= �5a�B' <br />FEES VALUATiON FEE <br />BUIIDItlG 5 _, <br />PLUMB�NG <br />1.1ECHANICAL <br />OTHER <br />STATE BUILDING SUF7CH�RGE <br />STATEENERG�SURCHnRGE <br />Pueuc wonKs <br />TOTAL <br />PROPERTV OWNERS AHE RESPONSIBLE FOF DETERMINING ALL <br />PROPEIiTY LINE LOCATIONS AND RELATED EASEMENfS. <br />