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p►PPLICATION f0(. <br />'"'`�'°'"" CONSTRUCTION <br />cm or <br />everett PERMIT <br />BUILDING DEPARTMENT TO BE COMPLETED IN INK • PLEASE PRINT <br />259-8810 <br />❑ OEMOLITION ❑ COMBINATION ❑ BUILDING Il MECHANICAL <br />_..._ .. raui ennmss . . , c�rv . � 21%L <br />ss <br />❑ PLUMBING <br />rnorrt <br />���nn <br />e <br />GFILd`J <br />PlUM8iN4 LONiR�C10R <br />nun .nnn�ss cnv t�v rians ucer�se • <br />:USSOf WORK <br />❑ NEW ❑ ADDITION �� ALTERn110N ❑ REPAIP ❑ OEMOLI110N ❑ WOODSTOVE/FRPL.INSERT BUILDING RELOCATION <br />r�iu���nw nr won. �cos��M��[nui s ruis i �eo�� <br />i �..... <br />pr <br />p� sd � <br />►�u�— <br />GI.7 <br />W�TER <br />NITCHEN SINK i <br />OISMW�SMER <br />LAUNDRVTRAY <br />CLOTMES WASH <br />URINAL <br />DRINNING FOU� <br />FLOOR DR�IN <br />ROOF �RI11N5 — M���'+�envc <br />SINK ISERVICE — BAR. ETC � <br />SUlTOTAL <br />pERMIT <br />TOT�L FEE <br />�uo�+tseie:r... ne•aseio�c+ <br />iis�tonE ior�n�. <br />ry�( OI CONtiI OCCOMNCY GP( <br />s¢e o� ui nc r�o or smn¢s <br />FEF <br />I HEREBY CERTIFY THAT I HAVE READ AND ExAMINED THIS AP• <br />PLICATION AND KNOW THE SAME TO BE TRUE ANDCORHECT. All <br />PROVISIONS OF LAWSAND ORDINANCES GOVERNINGTHISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br />IN OR NOT. THE GRANTING OF A PERMIT �OES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANV OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OFl THE PERFORMANCE OF CONSTRUCTION. <br />til(iN�I�IHEUILLUN111Af.fO11U(1AUO�OIUI4D�GLN1 U4ih <br />x /�.� . �C�� <br />r�n <br />MECHANICAL <br />A/C — MHN�LG UNITS — M P <br />REFRIGERA�ION UNITS — N P �� <br />001LER5 — B.T U /M P <br />GAS FIRE� � Q UNITS — B TL. <br />FORCEO PIR SYSTEMS — B T U M EA <br />W�ILMEATER3—BTU M <br />UNIT MEATERS — B T U M <br />EW PONATIVE COOI ERS <br />CLOTHES DRYEHS <br />VENTILATION FAN <br />R�NGEMOOD <br />W�TER HEATER <br />WOODSTOVE <br />METAL FIREPLACE 6 CHIMNEY <br />FIREPUCE INSERT <br />MEATPUMP <br />GAS PIPING —�� <br />EXHA115T FAN <br />SUBTOTAI <br />f / <br />{ ' P[RYIT <br />�- TOTALFEE <br />S 'i <br />s�oE sne.c. <br />I VIAn CMEGK NUMBER I FEE I RECEIPT NO. <br />wc.rn s�n <br />'JYL•v IINO <br />;ip OF DWfI <br />ioan <br />enr�i,eRnoei•r.t nv rinr�sc�rtenmev I�rrn ron <br />O.OV� <br />BUILDING 5 1 • �' <br />�� 1 <br />PI.UMBING <br />MECHANICAL <br />OTMER <br />STATE 9UILDING SURCHARGE <br />STATEENERGVSURCHARGE <br />PUBLIC WORKS <br />TOTAL l `, <br />PROPERIYL�INELOCA7�NSANONHE�LA7EDE SGM:�NTSINGALI <br />