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�-,PPLICATION f0�� <br />IMErNpnM CONSTRUCTION <br />�,n� <br />everett PERMIT <br />BUILDING DEPARTMENT TO BE COMPLETED IN INK • PLEASE PRINT <br />259•BB 10 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING 'MECHANICAL <br />_ _ M+it •oon, ss __ n � � '� �� <br />��/� <br />� <br />everell <br />e <br />❑ PLUMBING O SIGN <br />•`..•� — uen �uoncts cnr u� ........ <br />R(.NIIlC� O� UlS�UNEN <br />fikNE��L CONIR�GIOA <br />M�rt �PUIt6ti Cih !iP �nONC uCENSE • <br />M�i1 <br />]L�540� WORK <br />U ryEyy ❑ ADDI110N ALTERATION ❑ AEPAIF ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING REIOCATION <br />io�—eioc�- <br />1 V I'� � <br />r�urs�na <br />no. rrre or Fu <br />W�iER Cl04ET ITOIL <br />� e�n+rue <br />U�ATORV IWASM 8�: <br />SMOWEN <br />. KITCHEN SiNK � DISP <br />I <br />i <br />� 1FOH1lEIB�Ck <br />i USEZONF <br />iON �CC B� <br />— B�R. <br />w� <br />11EAR <br />Dr <br />� <br />veC�NicrtE <br />❑rE5 t]NO <br />NO 0� OWELLING UNIIS <br />M.. occ io•o <br />errn ron issuevice ev <br />I HEREBY GERTIFY THAT I MAVt Htnu nrvu cnnmmcu i nw nr <br />PLICATION AND KNOW THE SAME TO BETRUEANDCORRECT. ALL <br />PROVISIC�JS OF LAWSAND ORDINANCES60VERNINGTHISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORIiY TO VIOIATE OR CANCEL THE PROVISIONS OF <br />ANV OTHER STATE OR LOCAL LAW REGULATINGCONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. . <br />SIGN�IURE O!' CONiR�C10R Op AUT R12E0 �CENT O�TE <br />.X�� �,�f��� yl <br />�n �uT¢f1fvN11GN i5 ICEH9 NO <br />MECMANICAL <br />��c — ���No�a ur+its — N v <br />NEFFIGERATION UNITS — M V. Fi�. <br />BOILEPS — B.T.U.IH P <br />6AS FIRED A�C. UNITS — B.T.U. <br />FORCED AIP 9YSTEMS — B T.0 �� <br />W�LLHEATERS—B.T.U. M <br />UNITHEATERS—B.T.U. M <br />EVAPON�TIVE COOLERS <br />CLOTMESORYERS <br />VENTIUTIOH F�N <br />R�NGEMOOD <br />W �iER NEATER <br />WOODSTOVE <br />MEfAL FIREPLACE 8 CHIMNEY <br />FIREMACE INSERT <br />NE�T PUMP <br />6R5 PIPIN� <br />VLAN CHECN NUMBER <br />ITOTAL <br />IWT <br />fAl FEE <br />FEE <br />i <br />PECEIPT NO. <br />BWLDING 5 � <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BUILDING SUACHAPGE <br />STATEENERGYSURCHARGE <br />PUBLIC WORNS <br />TOTAL <br />PROPERTY L�INE LOCATONSANDNRELATED E SEMENTS.INO AlL <br />