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I�� EwrprNn <br />��rv o� <br />everett <br />BUILDING DEPARTMENT� <br />259-8810 <br />�tePPLICATI4N F�(?.Q� <br />CONSTRUCTIr N <br />PERMIT <br />TO BE COMPLETED IN INK - PLEASE PRINT <br />❑ �EMOLITION U C�MBINATION ❑ BUILDING CILMECHANICAL ❑ PLUMBING ❑ SIGN <br />Y R �7 C e. � <br />ovnrtn ✓J M�a�onn[ss �/ cl�h, nn rnn.rt <br />��� / ��A E�� i f019 �UoA�..I � _ �-- .i/� .�SriZ .�9L4 <br />• CM��LC1UNUt5�ii nER MAILLDUAE55 GI1V lIP n10N1 <br />f.fNCA�ICONiPeC�OB MA1lA00RE55 CIIV IIP �'40N1 LICCNSE• <br />....�...0 �.i �nrnmr�nn /1 M�IL ��ORL55 CIIY 21P PIIONf UCENSF • <br />❑ NEW ❑ �DOITION <br />..� o.nn�� nr wnn..cos� Or �.� <br />wnn. <br />c� <br />PLUMBING <br />WRTEP CLOSET �TOILI <br />BAiNiVB <br />LAVqiORY1WP5NBA', <br />SNOwER <br />KITCHF.N SINK 8 DISP. <br />OISHWASMER <br />LAUNORYiRAY <br />CLOTHES WASNER <br />UPINAI <br />DRINNING FOUNTAIN <br />FI.00R DRAIN <br />ROOF �A��NS — nnmitn�e <br />SiNN ISERVICE — BnR. E1C � <br />IIV <br />DN ❑ REPAIR ❑ OEMOLIIION ❑ WOODSTOVElFRAL.INSENT ❑ �UILDING FELOCATION <br />fOUR <br />SUs TOTAI � <br />PEflMIT f <br />� TOT�LFEE 3 <br />�upriiSE�O�f.r �nL�ASE�B�GK 510[ <br />r�pL Ot CORS� <br />ti�Z[ Of BIDU <br />°°°^ WGN15iiE <br />❑vE5 ONO <br />U1'ANGYGROUF NO.OFOWFLL�N <br />O� StORIES MR% OCG lOAO <br />inv�ccnr r�<H:artcKE�ev I>���fOP155UANLE <br />i HER68Y CERiIFY THA7 I HAVE REAO ANO EXAMINED THIS AM1 <br />PLICATION AND KNOW 7fIE SAME iOBE TRUE ANDCORRECT. AlL <br />PROVISIONS OF LAWSAND ORDINANCESGOVERNING T111St VPE <br />OF WORK WILL BE COMPI.EIEQ WITH WHETHEF SPECIFIED HEFE- <br />IN OR NOT. THE GRANTING OF A PEFlMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOIATE OR CANCEL THE PROVISIOPIS OF <br />ANY OTHER STATE OF LOCAL LAW REGULA(ING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. . <br />SIGN4TpPE Of CONIRA�G � OR RUL ORiZf.O AGENT f1AtE <br />X ����(%, �,.� /-� � x � <br />MECHAtiICAL <br />7vve oF evuivMen � <br />NC — A�MNOLG UNIT$ — I� V <br />REFRIGERATION UNITS — �+ P- EA. <br />�OILERS — 0.T U M P <br />G�5 FIPE� A.C. UNITS — B.TL. <br />FORCED AIR SYSiEMS — U T.U. ffSrM FA. <br />WALL��EATERS—B.TV. M <br />UNITHEATEflS—O.T.0 M <br />EVAPORATIVE COOLERS <br />CIOTnE50RVER5 <br />VENTILATION FAN <br />RANGEHO00 <br />WAT[R MEATER <br />wOODSTOVE <br />METAL FlREPLACE 6 CHdANLV <br />FIR[PIACE INSEflT <br />HEAif'UMP <br />i CAS PIPINfi _ <br />SUBiOTAL <br />PEPNIT <br />TOTAIFEE <br />RAN I:HECN NUMBER I FEE I RECEIPT NO. <br />FEES ��ALUATION fEE <br />OUILDING S <br />PLUMBIIJG <br />MECNANICAL � <br />orr+en <br />STATE �UILDING SU�7CHARGE <br />STATEENERIiYSURCHARGF <br />PUBLIC WORKS <br />TOTAL �' <br />PROFERTVLOINELOCATIONSA DtRELAEEDEASEMENiS�NGALL <br />