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f,PPLICATION FOf. ��� <br /> M.E~'°�.° CONSTRUCTION � <br /> pr o. <br /> everett PERMIT <br /> BUILDINC3 DEPARTMENT TO BE COMPLETED IN INK• PLEASE PRINT <br /> 259•8810 <br /> O DEMOLITION O COMBINATION E BUII.DING ❑ MECHANICAL ❑ PLUMBIN6 ❑ S�ON <br /> M�n�ooness cin nr nHONc <br /> ow„Ea 9r1 •� � z S� vs <br /> iL .2D � � i ,• ,.�. � <br /> �NCMItlC�OF UtS�ONEP <br /> M�i��DONE59 Cirv , Iio rv�OHL <br /> OkNEHqCONiR"��GtOP MNl�00RE55 Ci�V III• npONE 14:1•bf.� <br /> :��i,F <br /> � G1Y 2iP ���OME l�Cf4c1 • <br /> M1f.�UNIG4L Ht11�GlON M�IL�OpRE9! <br /> FWMpINOCONiR�C�OR M�IIAODPC54 GiY 211� PUONF IIlVISf • <br /> CL�53D�W�P�. <br /> ❑ NEW ❑ r:DO1tION ❑ ALTERATION � FEPAIR ❑ DEMOLITIOI! ❑ WOODSTOVE/FRPL.INSERT BUILDING AELOCA11p�!_ <br /> V�IU��IONOtWON�,�ys+y(�,�S•�S���e�,�^, ,- <br /> y3 <br /> ocscu�n[wnun � <br /> dciiic�.t �� i„� i�� r ,riJ'/>'., f/a��J• �— <br /> usf o�euno��in � I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THiS AP <br /> I� FS���fn tF_ PLICATIONANDHNOWTHESAMETOBETRUEANDCORRECT �L1_ <br /> �C(I�LOESCM�F��ONOtCpO�CRtY15NOWMBELOWO��11�GtlfOURCOPIE51 PROVISIONSOFLAWSANDORDINANCESGOVERNING7HISiVPE <br /> OF WORK WILL BE COMPLETELI WITH WIIETHER SPECIFIE011ERE� <br /> �o�_aioc�—or IN OR NOT.THE GRANTING Of A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEI THE PROVISIONS OF <br /> ANV OTHER STA1E OR LOCAL lAW REOULATINO CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCi�ON. . <br /> StON�IURE OF ONiN�CIOA O�AUtHOR12E0�GENT D�1E <br /> X L'1���-.�S� <br /> AP{QIL� i5 It BUSME55 �CENSE NO <br /> vROJECI�DOPE55 <br /> �Q r� �.1� �/� •7 ✓l� <br /> PLUMSING MECMANICAL <br /> NO. TNV!OF FII(TURE OR ITEM <br /> FEE NO. T'PE Oi EOUIPMENT fEE <br /> W�TER LLOSET�TOILET� 11/C—A/MNOl6 UNITS—N P. <br /> REFRIGEP�TIONUNI�S—MP EA. <br /> BIITMTUB <br /> UVAiCRV 1 WASH B�SINI BOILERS—B,T.0/N P. <br /> 6A5 FIRED A G VNITS—B.T.U. <br /> SHOwEN <br /> NITCHEN$INK 6 DISP FOPCE����7 SYSTEMS—B.T.U. M FJ�� <br /> WAIIHEATERS—B.TU. M <br /> DISHW�SHER <br /> UNIT HEATEAS—B.T U. M <br /> UUNDRYTR�V <br /> CIOTHES WASHER EWPOPAfIVE COOlERS <br /> CLOTHESDA�ERS <br /> URINAI <br /> VENTILATION F�N <br /> DRINKINO FOUNTAIN q�NGE HOOO <br /> fLOOA DAAIN <br /> BACKFLON'PREVENTERS WATER HEATER <br /> ROOF OR�INS—��INlEA0ER5 WOOD STOVE <br /> SINK ISEA��LE—�/��.ETC� METAI FIREFUCE 6 CHIMNEY <br /> FIREPLACEINSERT <br /> HE�T PUMP <br /> —� QAS PIPIN6 <br /> E%HPUSTFAN <br /> SUS TOTAL <br /> SUO TCTAI � <br /> VERMIT f P[RMIT <br /> TOTIIL RE f TOT�I FEE <br /> n�aq SE�B�Ca S�OE SE1B�Ctl PLAN GH{CI(NUMBER FEE �.� aECE�Pi NO <br /> �pUY�SCIBef.� Il 1"� � v� , � . .�i . � 1 <br /> i c%c _)�=(^�.� > /��1.`. � � �. � . <br /> �)� � 20 � -5- ,t, , <br /> u•.i�ont(� <<��•���� veuert snc FEES VALUATION FEE <br /> (\'� �'�-`C�O ,�J ❑res�+o S� / 3-� 7 <br /> — BUIIDING �j <br /> n��p�� qs� pr,CllvnllLYGPOU� NOO(�WFIIINOUN115 _ <br /> � ��/ t'a � PLUMBING <br /> y.. <br /> 52[o�eic, ��O O� S�OP�ES MAR OCC 10�� MECMANICAL <br /> i�� � r � N�a <br /> OTNER <br /> fIRE SP�IHKLF ' REOU�A�n u VES I�NO STATEBUILOINaSURCHAiiGE <br /> ' STATEENERGYSURCHARGE <br /> ��.i:�, ..��,�ye;, p, r�<r�SC��EcnEoer ���A �-aA�55U�NCE9Y pUBLICWORKS <br /> ; I�I� /� . � TOTAL <br /> pROPERN OWNERS ARE RESPONSIBLE FOR DETERMININO AU. <br /> PROPEFTV IiNE LOC�TIONS AND RELATED ERSEAIENTS. <br />