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ArPLICATION fOR ��e <br />m�E.+�Om� CONSTRtJCTION O <br />cnr or <br />everett PERMIT <br />BUILDING DEPARTMENT <br />25�J-88t0 TO BE COMPLETED IN INK- PLEASE PRINT <br />O DEMOUTION Il COMBINATION �BURDING ❑ MECHANICAL 17 PLUMBING ❑ SIGN <br />c�wa�n nun eUn�u...---_' �.nr zm r��nin <br />� F�, ��, �, t�, SE,� u�� R s�_ F✓�✓r.l'�' `) y�[�f �5.1—,��/.�— <br />I.IEII AIIlllil 15 f.11V jll` I�Ilnlll <br />,,; „�,�, � „W �;, .:�,:�<<, Z 7`i y — `/ z �P/ <br />1 r�r>!. C S S, �•it'�.—.—I��c,�'��r %y 7z <br />Inln�.LlJn �---_ �>�� t�P �•unNt I�C.[NSc. <br />IA�q �PI1111 51: �/ <br />���M C b �o�• �i, i . ;� 5 � Lr.�J; s —l1, "d `l3'..�'1� %`/�5�-9z9/ /Enicut /`�7pK <br />ru�nu.�r.i cnrne.nnn �.�an •nmuss rnr nr runni ncnis� . <br />riue�oia,mr�m�r.�nn �.�u� nnni.is�. --�_--__�__—_r tir r��orn nc:�.r�si . <br />ci .ss a� wn�,. <br />�NEW ❑ ADDITION ❑ ALiGFA1WN <br />rq u�uon or w�w. a:nst nr uattn��i s ri us i�nrni� <br />n�scnmi <br />us� <br />t[f.0 nlSCA�P��M�O� onor[qtr <br />wi_u�x�_.o�_ <br />i0iEC1�pOBE55 <br />�.�3 ` <br />PLUMOING <br />WATEA CLOSET �TOLLEII <br />BATMTUB <br />LAVATORY�WASMBASINI <br />Ic1TCMEN SINK S OISP <br />DISMWASHER <br />I�uNONVTR�Y <br />FLOOR <br />�l�urn sr�.la:c. <br />utit lONt <br />�vi�i. ni r.o�� <br />J <br />sin ar m nc <br />576 <br />OR�INS — R�WLEADERS <br />iFRVICE — Or1p. ETC, � <br />F <br />YUB <br />TOTALFEE <br />n�.n sE�e•ca <br />�m�nu ZM <br />NI:PAIfi ❑ DLMInI11Ur1 ❑ WOODSIOVElFRPIJNSERT <br />F(�le���' - <br />L '/ ��l Z `i � <br />on .i r+c� � i om� coric s� <br />.r.� v�«: �...t_�-- <br />❑ BUILDINU NELOCAIION <br />I HEREBY CERiIFY THAT I fIAVE READ AND E%AMINED THIS AR <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWSAND ORDINANCES GOVERNING TIIISTVPE <br />OF WORK jMlk1 COMPLETE[1 WITH WHETHERSPECIFIED MERE• <br />IN OR �IPJ7. TI1E G ANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVFiAUTHOHIT T-VI LATE OR CANCEL THE PROVISIONS OF <br />ANXOTHERST ORL CALLA REGULATINGCONSTRUCTION <br />O� iHE PERF �NC OF CO STFUCTION. <br />S aN<IIiNL OI CU� i'4GG ON AUD IULE� AGINI 04iE <br />t.111 Ou;:M[ti51 <br />MECMANICAL /y'vx�� <br />FEE NO. TYPE OF EOUIPiwE <br />AiC — ��MNDLG UNITS — M P <br />REFPIfiERATION UNITS — H P EA. <br />BOILERS—BTU�MP <br />GASFIREDAC UNITS—BTU <br />FORCEO A�R SYSTEMS — B T U <br />WALL HEATER$ — BSL. <br />UNIT I/EATERS — B T U <br />EVPPORATIVE COOLERS <br />CLpTNESDRYERS <br />VENTILATION FFN <br />qANGE 1100D <br />WATER HEATER <br />WOOOSTOVE <br />MHTAL FIREPLACE 8 CIIIMNEV <br />I/EAT PUMP <br />GAS PIPING <br />E%��AUST FAN <br />:IOFf.K '� �N CMEC,H NUMBEH <br />. �Si��A..� � ��`,;��) �� ��1�' . � � <br />IYLS xRU <br />oarmm�i <br />11001`:1�f5 / �I.IPr:Of,G <br />� � <br />pini�sia�Ecrcmor <br />!� <br />ron <br />1 �+ <br />SUB TOTAL <br />PENMIT <br />M EA. <br />M <br />M <br />� /L.� <br />FEE RECEIPTNO. <br />. — � �' �_ <br />,_. ' �-�% %<��Li <br />�..���.nnu FEE <br />OUILDINC 5 <br />PLUMdING <br />MECHANICAI. <br />O711flH <br />SiATE BULLD�NG Sl1FCNARGE <br />STATEENERGYSURCHnHGE <br />!'UBLIC WORKS <br />TOTAL <br />PROPERTY LOINE LOCATIONS ANO REBATED EASEMENTISING ALL <br />