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,, <br />�PPLICATI�ON FO�.' <br />'"'E"'°'"" CONSTR��CTION <br />cm or <br />everett PERM�T <br />BUILDING DEPARTMENT <br />259•8810 TO BE COMPLETED IN INK - PLEA�E PRINT <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MGCHANICAL PLUMBING <br />,,.....�.. MM/ ApORE55 ./ CIIV ZIP PIIONE _—�— <br />❑ SIGN <br />�RCMRECL OR �ESiGNEP n1Ait AIIOR[55 G1V ZI� PH�N[ <br />GENER�L GONTRNCiOR Mul app(iC55 �]itv dP i9�ONF IiCENSE • <br />MAIL <br />arr <br />''f5tr S�6 Sw��• <br />CIIT <br />IICENSk / <br />.3Ne /��,t-�.3aKA <br />I IfFNtiF • <br />CLASS F WORR <br />NEW ❑ ADDITION ❑ ALTERATION ❑ FEPAIR P� DEMOLIIION ❑ WOODSiUVElfRPL.INSERT ❑ BUILDING flELOCATION_ <br />NAiERIRIS PLUS I.FtlONI <br />�ib'a� � <br />no.'Ls r� /k <br />; -7. <br />LUt_ <br />PLUMBING <br />WATER CLOSET (TOILET� <br />BATMTUB <br />LAVATORV�WASM BASIN� <br />SNOWER <br />KITCHEN SINK 6 DISP. <br />DISNWASHEH <br />LAUNORVTRAV <br />CW7HE5 ��"�ASHER <br />URINAL <br />OPINKING FOUNTAIN <br />FLOOF ORAIN <br />BACKFLCW PREVENTERS <br />ROOF �RAINS — RAINLEAC <br />SINK ISERVILE — BnR. ETC <br />SETBACN <br />dR <br />�=JT <br />SUB TOTAL f <br />PEPMIT f <br />TOTAL FEE f <br />PSETB�CK S�OE <br />� <br />,���lGil/�/!'v <br />I HEREBY CEFlTIFY fHAT I HAVE READ AND EXAMINED TFi1S AP• <br />PLICATION AND KNOW THE SAME TO BE Tr7UE ANDCORRECT. ALL <br />PROVISIONS OF LAWSAND ORDINANCESGOVERNINGTHIS TYPE <br />OF WORK WILL BF COMPLETED WITH WHETHER SPECIFIED HERE• <br />IN OR NOT. THE GRANTING OF A PERM�T DOES NOT PFESUME TO <br />GIVE t1UTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANYOTF�ERSTATEORLOCALLAW E LATINGCONSTRUCTION <br />OR THE PE�RFORMANCE OF O TION. <br />SIGNAiIifjF[7�'�HIRn GRORA T 1 E A ENI P4iE <br />�� �-� ��`6 <br />„��,,,�F�S � ��� <br />/',l/� <br />MECHAWICAL <br />FEE NO. TVPE OF EOUIVMENT <br />G A�C — AMNOLG UNITS — H P <br />FEF�iIGERATION UNITS — H P EA. <br />BOLLERS — B T.U.�H P <br />GAS FIBED A C. UNITS — B.T.U. <br />FORi�F.D AIR SVSTEMS — B T U. M EA. <br />WALi. MEATERS — 8 TL. M <br />UNITHEATERS—B.TU. M <br />EVnFORATIVECOOLERS <br />� CLO1'HES �RYERS <br />VEN'ILATION FAN <br />RAnCiE HO00 <br />WAT:R HEATER <br />WOOD STUVE <br />METAL FIREPI.ACE 8 CHIMNEY <br />FIREP!ACE INSERT <br />MEAT PUMP <br />GAS PIPING <br />E%HAIIST FAN <br />� SUBTOTRL <br />PERMIT <br />TOTALFEE <br />P�AN CHECN 4UMBER I FEE <br />rec <br />HECEIPT NO. <br />USEZONE LOTAP[� vacnr�rsir� FEES VALUATION fEE <br />❑VES IlNO g <br />eUILD�NG <br />TYPEOFCONST OCCUPANLYGROl1P NOOF�WELLINGUNITS <br />PIUMBING <br />512E OF OIOG NO Of S10RIE5 MA% OCC IOnD MECHANICAL �� <br />OTHtR �� <br />FIRE SPRINKLERS REOUIREO ❑ YES ❑ NO __ STATE EL�ILDI�IG SUPCHARGE �� <br />STATE eNEn:i:Y =iUHCHARGE <br />4NPlIGIlONSCf, flY PLANSCMELHEOBV �PPIi fORIS5l1�NLE6Y PUBLI�:WORH'i � <br />�TOTAL � <br />PROPERTY JWNERS ARE RESPONSIBLE FOF DETERMINING ALL <br />PROPERTY -�NE LOCATIONS AN� RELATEO EASEMENTS. <br />