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m. [v.,prNn <br />C��'I o1 <br />everett <br />BUILDING DEPARTMENT <br />259•8810 <br />hPPLICATION FOh <br />CONSTRUCTION <br />PERMIT <br />TO BE COMPLETED IN INK- PLEASE PRINT <br />everen <br />� <br />O DEMOLITION ❑ COM9INATION ❑ BUILDING ❑ MECHANICAL H'GLUMBIN6 ❑ SIGN <br />owr.r.w ..ui.omass � arv rm rr�nv� <br />�'EKNn Q�SF� �.I1� Wv��Nur fl'�`iL�Fri' 9liwi 2tt-�x3� <br />� � : � ,N� <br />c�fr I° ,,, <br />GfNfR�l�ON1A�OIOP M�II 41UII154 C��Y bP •�'41 UC19v! • <br />I�9�bA�� lPr�sT ^�-13L N/(N�t*+b AN� EVl/�� NyJ 9Bu� tS�-'l Yso N4c(yfcy2��'c�� <br />... _......_.. �...»...�...e Mui eoontss r.i r r r e i c � <br />%U4��N�)COM�P�G1011 M�IL��I)�[55 . GM1 lll' Init�•11 Ullr��� • <br />DA✓f /SE/tY+Ef PAG• <br />a.se o� wo.+ . . . <br />❑ NEN' ❑ A�DITION ❑ ALSERATION ❑ AEPAIR ❑ OEMOI.IiIUN ❑ WOUOSTOVElFRPL.INSERT ❑ BUiIDiNG AE�OCatiO�i <br />V�IU�IIONOfy/�PYKO5101r.uq�n�isrursl�nnm . . ' ' . <br />USE U� <br />O� <br />to�—eixti— <br />�y tiv lNr��.✓� r <br />PLUMSIN6 <br />NO. TYPE OF <br />UVATOAY �WASM B�SINI <br />SNOwEN <br />RITCMEN SINK 1 DiSP <br />D�SMW�SHER <br />LAUI/DRYTFAY <br />URINAI <br />DRINNING FOUNTAIN <br />FLOOR ORAIN <br />6ACNFLOW PPEVE��TERS <br />RpOF DA��NS — �7MHLEAO <br />SINN ISERVICE — 0��, ETC <br />rwe Or coNs� <br />92E O� Bl D6 <br />FIRE SPPINf <br />.rci��.na� • <br />OA <br />SU! TOTAL <br />FERMIT <br />TOTAIFEE <br />�R�a SE IB�Gn <br />IOf�HEA <br />occuvu+crcnouo <br />I 11EREBY CERTIFY THAT I HAVE READ AND EXAMINED TIIIS AP� <br />PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT ALL <br />PROVISIONS OF LAWSAND ORDINANCESGOVERNING TNIS TYP[ <br />OF WORK WILL BECOMPLETEO WRH WHETIIERSPECIFlED MERE• <br />IN Ofi NOT. THE GRANTING OF A PERh71T DOES NOT PRESUME t0 <br />GIVE AUTHORITY TO VIOIATE OR CANCEL THE PpOV1510N5 OF <br />ANY OTIIER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. � <br />S�GN�IURE O� CONIR�CTOR Ofl �UTHORi2EU �GENf P+IL <br />X ��� <br />rruc.Nrs crtr eusi�� ss ur.v <br />MECHANICAL <br />OF <br />— 11iHNOL6 UNITS — H P. <br />airFasilouuNl7S—MP EA. <br />BOILERS — B.T.0 A1P. <br />GAS FIRED ��C. UNITS — B.T.U. <br />FOACED�IfiSYSTEMS—B.T.U. M <br />W/ILHEA7ER5—BTU. M <br />UNITHEATERS—BTL. M <br />EVAPORATIVE COOlERS <br />CLOTHESOA�ENS <br />VENTILATION FAN <br />R�NGEHOOD <br />WATERHEATER <br />WOODSTOVE <br />METAL FIHEPUCE 8 CHIMNEY <br />HEATPUMP <br />GAS PIPINO . <br />E%MRUSTFRN <br />! <br />f <br />f � <br />SmE SCIB�GK � ��N CMECK NUMBER <br />V�L�Nf S�II <br />OYES UNO <br />BUILDING <br />PLUMBING <br />FEES <br />OCL IO�D I MECHANICAL <br />nr �v>��scuccK[oor 'erpn roni55u�r+cE <br />��� <br />SUlTOTAL <br />PCRMIT <br />TOT11L fEE <br />FEE <br />VALUA <br />I S <br />FEE <br />RECEIPi NO. <br />OTHER <br />STATE BUILDING SU�CHARGE <br />STATEENERGYSURCMARGE <br />PUOLIC N'ORNS <br />TOTAI I <br />PFOPERTYL�INELOCATIONSANORElATEOE SEMENTS.ING�LI <br />r <br />