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� <br /> , <br /> ,�.E�.,`,�� �CONSTRUCTION <br /> Gry af ���,�M <br /> everett PERM�IT e <br /> BUILDIIvG DEPARTMENT <br /> 259�8745 TO BE COMPLETED IN INK• PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATiON �BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ S�GN <br /> owrcn � uuieoon s cirv zia or�or+e <br /> � �; . . ��EMc+� � iu��� �� F�k�a�l ���� � ���. - ia <br /> •numItcronmsicHti� u�iieooe�ss <br /> • Y�1�fJ �s � cm z�r wwr¢ <br /> il� ti1 � C_Vl <br /> U�N[M��ON�nnC�on M�R AoonE55 c�rv z�n ptlorrt ����qy� . <br /> IAI GIAtUGI GO������CiOf{ M�IL�OORE55 . �IIY LIP MIONC LICINU • <br /> �1UM01NliCO11�q�CI08 MAi��pOBE55 CIiY plp �ryON[ LICC9tiE • <br /> CU5501\VOOK� <br /> ❑ NEW U` A�DITION ❑ ALTERATION ❑ FEPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPl.INSERT ❑ BUILDING RELOCAIION <br /> v�t u+i ioH or wonK ir.o,�o�4iutuis rtUs uoon� _ <br /> ���/\._I '� <br /> ot sCnnn woi <br /> A�� �-� ,J t' �_ ,c, sT i �1 c�< oN E,ar c c <br /> utir nr ounnnm � l\ .� F <br /> 7 I HEREBY CEFTIFY TH�T I HAVE READ AND EXAMIN[D TIiIS AP� <br /> {,�F��' �� ' � D –� �' � PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.�LL <br /> ucnioesunnuor+orvno EN�YISMpWNBEIOWON�R�GNfOURCCIPI[5� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE� <br /> ioi_o�oc�_ov IN OR NOT.THE GRANT�NG OF A PERMI7�OES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PEFiFORMAN E OF CONSTRUCTION. <br /> SICIfil7UR�8�NiqACiOF AUf�1Q1i11EDA4ENf p4t[ <br /> � � <br /> X � <br /> � rg $,�, <br /> ✓ROJfC�AUDPE55 �� L� f�rj I •PPLICA CNTOUSMESSII�EN5EN0 <br /> 3 �4-I ' I u.�.�> �i r� - r�4��-ti- �n <br /> PLUMOING MECMANICAL <br /> _NO. iYP�OF FI%TUPE FEE NO. 7YPE OF EOUIPMENT FEE <br /> _ \YATEi7CLOSET�IOILEn AIRCOND.UNITS–NP.EA. _� <br /> _ BA7NTU� REFRIGERATION UNITS–HP [A. <br /> LAVA70RVIWASH 04SIN� �OILERS–H.P.EA. <br /> __ SNOW[R GAS FIRED AC UNITS–TONNAGE EA <br /> __ KIICIIEN SINR 6 DISP. FORCED AIR SYS7EM5–B.T.U. M E� <br /> DISIIWASHEii WALLHE0.iER5–B.i.U. M <br /> LAUNDRV TfiAY UNIT NEATERS–O.T.0 M <br /> CLOTHES WASHER EVAPOR4TIVECOOLERS <br /> __ WA7ERHEATEfl CLOTIIESOfiYERS <br /> _ URIII�L VCNTILATION FAN <br /> __ DHINKING�pUNT�IN RANGE HOOD <br /> – _�._'–_' <br /> _ FLOOR ORAIN AIR HANOLING UNIT– CF.M. <br /> _ VACUIIhI BREAKEfiS STOVE <br /> ROOFDRAINS–RAMlEA0ER5 METALFIREPLACEd CHIMNEV <br /> SIHK�SERVICE–�AR,ETC. WOODSiOV[/FIREPLACE INSEf7T <br /> __ SUU TOLAL SUB TOTAL S <br /> ___ PEPMIT 5 PERMIT S <br /> ___ TOTALFEE S TOTALFEE __ 54___ __ <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> �IIUf115LI��f.R NL�p5C�I1RCK SIDESCIO�ICR fUNC11ECNH IOEB PIANCHILnI(L <br /> N,� � /'l�\J "2 rc[ .-�/�v ntcar�mo c 1 <br /> /tJ J �U �� �q�� <br /> UA 2p11[ l01 Afl!A � �jJ` r yAC�Ni SRE — <br /> K ' � ��SOv aSl ��[5 X110 FEES V�IUAiION �EE _ <br /> �H9qlf.pN(5�1 OCNI'ANCYGIIOUP NO.OIOWELIINQUNIIS / 1SO <br /> �� �/V ��� i� ._t--_ _ <br /> DUILDING S 5�/ �` � <br /> Slll UI A111 P/C NU Ui SIORik9 M�%.00C LOAO _ _ __ <br /> /�/ , ��� '`� � PLUAIDING <br /> MECIIANIGL <br /> fIRG SPfiINNLEi7S RLOl11RCD ❑ YES PI NO — <br /> OiHER <br /> PENALIY — _ –'"' <br /> nl'1`IiG�liON�Gf, pY PUNSCB[CNEOBY RP!'R.(OPILSU�NGE�Y __ <br /> s� c�Fr- To,A� 5 5 5�J <br />