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�cPPLICATION fOf.J' ���.�M <br /> �ME�ro� rONSTRUCTION O <br /> cr� <br /> everett PERMIT <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK- PLEASE PRINT <br /> 259•8810 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BJI�_DING ❑ MECHANICAL ❑ PLUMBING ❑SI(iN <br /> MML AD��L55 ��n' J�P PNONE <br /> o,..Ea 3�8 S� /.�v� /Jv'- 6hee�fi <br /> � . u/I <br /> • Qiv Z�r PNON[ <br /> ♦RLNI�fCIORUlS�QNBI M��l �OOIIL55 <br /> M�II�OOR[55 C��v /� b�/] �uONE IICENSE• <br /> GFNEA�lCON1R�C10u r� �IJ j� E('CHQ(! •p^OS <br /> - Mr �3u��� �I���rtq �'tmsTt 99.�`� � — <br /> MECN�N�UI CONiP�LIOq <br /> M�R�DORE55 CrtV IP P ONE lGE SE <br /> c�lv In• ���ONE uCENS[• � <br /> PWMl�NOCONiN�CIOR M�Il�O��[55 I <br /> Cl�SSO!WOAK , <br /> ❑ NEW ❑ �DO�TION ❑ AL7EPATION ❑ PEPAIR ❑ O[MOLI110N ❑ WOOOSTOVE/FRPI.IHSERT ❑ BUI�DING AELOCAiION I <br /> W W�1�ON pf W O��IC051 O�M�I C A���S 1`U15 L�P0111 <br /> � <br /> OFSCAiBE WOAK � <br /> � � /%v �.ti N� Sl�ae% ' .Sa�a//�s� <br /> usc or ewio��a . /���� I HEHEBV CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> � s�;�,,��,o �Qu{j/� �i e5/ Cr PUCATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL i <br /> LEO�lUESC T�ONO��AQ°ER1Y19��OW eeiowou•i c ounco es pROVISIONSOFLAWSANDORDINANCESGOVERNINOTHISTYPE I <br /> OF WOfiK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br /> ioi—eioc.---o' IN OR NOT.THE GRANTINCa OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUiHORITY TO VIOIATE OR CANCEL THE PROVISIONS OF <br /> ANV OTHER STA7E OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. . <br /> SIGN�IUN CONIR�CIOROAAUi110A�ZE0<GENT [I�TF. <br /> X , � 3r3/�88 <br /> ♦OPIi T9GivBU5wE45UCEH5EN0 <br /> VPOJECt�0UPE95 <br /> � 3 � e S�r /.ti� fJ� ��Ner�` <br /> MECMANICAL <br /> �LUMSIN6 �E <br /> NO. TIV[OR fll[TU11[0111TEM FEE NO. T/P!OF EOUI►MlNT <br /> I A/C-AMNDL6 UNIT$-N P. <br /> W�iER CLOSET ITOIIETI <br /> PEFRIGERATION UNITS-MP.EA. <br /> BAMTUB 1 <br /> BOILERS�-B.T.0/H P. <br /> uV/1TOHY�W�5/1 B�SIN� <br /> O�5 FIREO�C.UNI�S-B.T.U. <br /> � SI�ONIFH <br /> 1(!:CNEN S�NK 6 DISP FOPCED AIR SYSTEMS-B.T.U. M F�� <br /> WALLHE�TERS-B.T.U. M <br /> � DISHN'115MER M .. <br /> � � UUNDRY TRAY UHIT MEATERS-B.T.U. j <br /> EV�PoRA7IVE COOLERS <br /> CIOTMES WASMER CLOTMES DAYERS <br /> � �JNINAL <br /> VENTIUiION FAN <br /> DR�NNING FOUNTAIN R�NOE MOOD � <br /> � FLOOA ORI11N <br /> WATEN HEATER <br /> � B�CNFLOW�EVENTENS �ypOD STOVE <br /> RpOF DR��N$-NAMIFJ�OEFS METAL FIREPI+�CE 6 CH�MNEY <br /> SINI(ISERVICE-B�N.ETC� FIFEPUCE INSEPT — <br /> HEATPUMP <br /> GAS�IPING <br /> ! EXHAUSTFRN <br /> , EU�TOTAL <br /> ' fU!TOT�L � p(�MIT <br /> PERMIT � TOTALFE! <br /> TOTAL FEE s RECEIPT NO. <br /> ' PIAN CHECR NUMBER FEE <br /> IRONTSE1B�Ck AE�ASEI6�GK S�DESEIMLK <br /> � VALUATION FEE <br /> use zoHe �onnc� y�G�Ni S�IE FEES <br /> j pr!:� oNo BUILDING s <br /> TVPEOfCOH51 OCCUPANLYGNOUf' NOO�DWELLM(iUHifS <br /> PLUMBING <br /> Si2E Or B�oa Ho ov sroaiEs MAY OGL IOAD MEGHANICAL <br /> � <br /> � OTHER <br /> i FIRE SPRINNLERS REOUIRED O YES O NO ST�TE BUILDING SURCMARGE <br /> STATEENERGYSURCHARGE <br /> �PP�i��110N�GC BV �L�NSCIIELMEOBY �PCIi fOR155U�NGEBY PUBLICW�RI($ <br /> TOTA:. <br /> � <br /> PHOPERTV OWNERS ARE RESPONSIBLE FOR DETERMININ�ALl <br /> PROPERN LINE LOCATIONS AND RELATEG EASEMENTS. <br /> i <br />