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, .PPLICATION FO�. ���,�„ <br /> ,".`"'°'"" CONSTRUCTIGN 0 <br /> un or <br /> everett PERMIT <br /> BUILOING DEPARTMENT <br /> 2S9-8B10 TO BE COMPLETED IN INK- PLEASE PRINT <br /> ❑ nEMOLITION ❑ COMBINATION O BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> �WXCR M4LIDORC55 CIiY lr� PIIONE <br /> �r'lin !1'1 7��n►'1��'� «�� � �1�Y��i' 9RaUl �5a-�8`� 1 <br /> �RCNrtCGiOADfS�GrvfR M�II�UOA[55 Gitt I ON! <br /> GfMCA�LCO•^M�N�CiOA MAq 10pRC5i C�N IIP VHONE LICCNSE• <br /> �'� l� <br /> MCLH�N�C4 CONtR�C1OF M4�1�ODRE55 C n' I CMO4E LICENSE• <br /> �'IVMB�MGCOHIB�CIO�i M����DDAE55 Gn' Ziv Pi�ONE UCENSE• <br /> C1�550�WOAK <br /> ❑ NEW ❑ A�DITION ❑ ALTERATION IRI REPAIR ❑ DEMOIITION ❑ WOOD$TOVE/FRPl.INSERT ❑ BUIl01NG RELOCATION <br /> WlU�T10N Of WOA�ICOSi J�MA1CA��15 RU$L�BOAI {y <br /> � <br /> DESCA�lE WOPr. , <br /> USE O�BUiIDiNG I HEREBY CER7IFY THAT I HAVE READ AND EXAMINED THIS AP� <br /> PLICATION AND KNOW THE SAMETO BETRUEANDCORRECT.ALL <br /> IEG�iDE a� n NO��>AO�ERiY15NOWN owoa +rac�r uncoo�es PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> OF WORK WILL BE COMPLETED WITH WHETHEH SPECIFIED HERE• <br /> �or.--Bia,�—or IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OA LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE Of CONSTRUC?ION. ��//D� <br /> SIGN�TUR�OiCONiRAGTGAORAUiHOR12E0�fENT D�TE Q <br /> �.�'�� � �-r�.,-.�.�.� <br /> P110JEGT�DOPC55 APP�IL�NTS CIiY BUSINESS IiCCNSE NO <br /> rIUMlING MECHANICAL <br /> MO. TtPE Of FIfITURE OR ITEM fEE NO. NVE OF EOUIVMENT �E <br /> W�TER CLOSET 1�OILET� A/C—�/HNOLG UNITS—N P. <br /> BATMnB REFRIGEPATION UHITS—M P.EA. <br /> U��TORv�WASM BASINI BOILERS—B.TL.M.P. <br /> ��R GAS FIPED A�C.UN'TS—B T.U. � <br /> KITCMEN SINN�DISP. FORCEO��R SVSTEMS—B T.U. M EA. <br /> pl$1�V/i45MER WALL HEATEFS—B.T.U. M <br /> UUNDRYTRIIY UNITMEATERS—B.T.U. M <br /> CLOTMES WASNER EVAPORATtVE LOOLERS <br /> UNiNAI CIOTHESORYEPS <br /> DRINKING FOUNTAIN VENTII.ATiON FAN <br /> FLpOR DRAIN RANGE HOO� <br /> BACKFLOW PREVENT[RS W�TER HEATE9 <br /> RpOF DRAINS—RAINLEAOERS WOOD STOVE <br /> SiNK�5£RVICE—BAP..EiC) MEfAL FIREPUCE 6 CHIMNEV <br /> FIREPLACE INSERT <br /> MEATPUMP <br /> GAS PIPING <br /> - E%NAUSTFAN <br /> SU!TOTAL t SU!T0T11L <br /> PERMIT f PERMR <br /> TOT�LFEE f TOTALFFE <br /> �uOrviSETB�G� FE�H SEiB�CK SIDE SEiB�GK <br /> PLAN CHECK NUMBER FEE NECFIPT NO. <br /> USE20NE �o*�eu vnar+rsne FEES VAIUATION �E <br /> OVES ONO S <br /> BU��DiNG <br /> M1nEO�COMST OCCUP�M�YGROUP NO.OLOWELLINGUNIIS <br /> PLUMBING <br /> SiEE 0�PLOG NO O�S�ORiE9 M�xAGG IOA� <br /> MECHANICAL <br /> OTHER <br /> FIRE SPR�NKLERS FEOUIRED ❑rE5 O NO STATE BUILDING SUfiCHAriGE <br /> STATEENERG�SURCHAAGE <br /> ecoiiGcnnn�Cc B� vuNSCMECKED Bv �coR rOe i55U�NC[B� pU�LIC WORKS <br /> _� ?OTAL <br /> PFOPERTYLOINELOCA70NSANDNREBATEDEASEMENTS.INGALL <br />