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`�.PPLICATION f0� <br />'"'`"�'"° CONSTRUCTION <br />c�n or <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK- PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION O BUILDING ❑ MECHANICAL y�x[.umnlNG <br />_ .. _ ...,, .,.��,�.� cm ziv mwNc <br />❑ SIGN <br />I�fj�JON %�7�L- �C-��,.t�r Cv JF�l <br />♦��ItLC�OND!}iGN(N MUTADpPLSi CI1V ll[� PMONL <br />�•1 ylN�t CUN1P.1�tO11 MI,�I H1UR[55 C�tt Z�P �'��ONC L�CEIISL • <br />�AC-l.l)�Sl� 10S�.�i Nu�N `�`i So�,iL. ��'ruEt( 34y'!`�S1_ <br />MlCrl�Nif�1 C�1111fU010fl M�Il1lIpNl55 b(V ZIO PIIONL UC[NSf. • <br />nW iu9iN�i CO�+1�• <br />��� i-e r��� •, i t�i c<< <br />��.550� w�A.. <br />❑ NEW ❑ ADDITION 0 AL <br />cµ Wi:OH Or wCn, d'J51 io nuitauLS rt� <br />OCSCNiPL WJuw <br />Rtist��.� c c= <br />u5f O� BGtD�nG n <br />io�—e�oc�— <br />iOlEC1�0UMCJ0 <br />aaac� sU��, <br />v�uMsiNc <br />NO. T'PE OF FlIITU <br />W�TEN CLOSETITOILETI <br />BATHTUB <br />LAVATORY IW�SM B�SINI <br />9Yf1@ <br />NITCHEN SINK 6 DISP <br />OISNWASHEN <br />UUNORY TRAY <br />LLOTMES WASHER <br />URINA� <br />OR�NNING FOUNTAIN <br />FIOOR DAAIN <br />nvur unnina — <br />SINK �SERVICE — BAR. ETC 1 <br />SUSTOT�L <br />PEPMIT <br />TOTALfEE <br />�� <br />nE�R SEiO�LK <br />i�.00ucss c�rvFi.212FTi21n yE�pE w�or�E iicr.��c. <br />�,� 3�i-N 5�. �„fReti v�.}�� w� J> 349-899G cfNSF, i'. <br />r <br />ION ❑ AEPAIR ❑ OEMOLITION ❑ WOODSTOVE/FRPL.INSER7 ❑ BUILDING RELOCATION <br />.iva� <br />V�C�NT SitE <br />OYES �NO <br />NO Of DWfI <br />M>z OCL <br />APPq fOR <br />I HER[BY CERTIFV THAT I HAVE PcAD AND EXAMINED TNIS AP• <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF L.AWSAND ORDINANCESGOVERNING THISTYPE <br />OF WORK WILI BE COMPLETED WITH WHETHER SPECIFIED HERE• <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUMF. TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANV OTHER STATEOR LOCAL LAW REGULATINGCONSTRUCTION <br />OR THE PERFORRIANCE OF CONSTRUCTION. . <br />SIG4n7URB0 ONLR4CTOFOIiAUi OF4[OAGF.NT D/.TE <br />X -�� �u ��/� � - 3 - e7 <br />APPLIf.�NTti CItY BUS�NE 5§IrGlIISCNO� <br />MECMANICAL <br />A/C — AIMNOLO UNITS — MP <br />REFRIGEH�TION UNITS — M P. E <br />901LER5 — B.T.0 M P. <br />GA$ FIRED A C. UNITS — 0 T.U. <br />FORLEO �IR SYSTEMS — B.T.U. <br />WALL HEATERS — BS U. <br />UNIT NE�TERS — B.T.U. <br />EVAPOAATIVE COOLERS <br />CLOTNESORYERS <br />VENTILATION FAN <br />PANGEMOOD <br />W�TER MEATER <br />WOOD STOVE <br />METAL FIREPUCE 8 CMIMNEV <br />FlREPIACEINSERT <br />PIPING <br />�UST FAN <br />i�I.AN CHECK NUMBER <br />SUBTOTAL <br />P[RMIT <br />TOT11L FEE <br />�� <br />IFEE <br />�UILDING 5 <br />PLUMBING <br />MCCHANICAL <br />OTHER <br />STATE BUIIDING SURCMARGE <br />STATEENFRGYSURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />RECEIPT NO. <br />r, <br />PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING ALL <br />PROPERTV LINE LOCATIONS AM1D RELATED EASEMENTS. <br />