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�i i <br />, �, S • � �• ' ..'�''��1 ,'. <br />, �.. �,�� ; ,. � . � <br />ti.'PLICATION FOR: � ���,�n �;: <br />��� EwrprNn CO N ST R U CT i O N � i�',� <br />em or � � <br />� everett PERMIT : ��`�` <br />BUILDING DEPARTMENT I � <br />' TO BE CGMPLETED IN INK • PLEASE PRINT �':+, <br />259•8810 "i <br />� ❑ OEMOLITION ❑ COM9INATION ❑ BUILDIN6 �MECHANICAL ❑ PLUMBINO � ❑ J�4N ' <br />� MAII�DORE59 CITY 21P PHONE <br />� °W��,� no.��s - sM �T� ��� - 3 � ST �U� �.5.� - 3 98/ , , <br />, �RGNiIECTOPDf9�ONER MAll�00RE99 . Cltt Z�> PMONC ,'.i,,:. <br />� _UCENSE • � <br />, _ . .______ CIIY LIP GIIONE . � . �.•'� <br />zY �/�T�. <br />� PLUMBi110GONtRAGtOA <br />� CL�SSOi WONK <br />. ❑ NEW ❑ ADD�TION <br />VeLO�t�Of10� WOAM� ICOST OF IA1 <br />I <br />�v aoa�� - � <br />CIIY <br />�v •�l� � <br />tIP P11 <br />CD Z �fF7� <br />- 7JJ - 7L <br />LICENSE • <br />37�� <br />ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVEIFRPL.INSERT ❑ BUILDING RELOCATIUN <br />RiBEWGHN � C/ � J �U.e� � w�')TE/Q. ��ii�r � �+� <br />.�STA` . <br />�v eu��o��c I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />,�j'/�(E,7G� �j�M �` PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.AII <br />T I TYPE <br />ioi— <br />�ROJECi�UDRE55 � <br />: ��8-3� s— <br />PWMBING <br />TYPE OF <br />W�7ER CIOSET IT( <br />BATHTUB <br />6AVATORVIWASHI <br />SHOWER <br />!fITCNEN SINK 8 DI <br />[11SHWASHER <br />� n� iunRY TR�V <br />UA�NAL <br />ORINKII <br />FLOOA <br />SINK <br />�np��I SEIO�Cn <br />cO��sT <br />� <br />� <br />voun <br />PROVISIONSOFLAWSANDORDINANCESGOVERNING HS <br />OF WORK WILL BE COMPLETED WITH WHETHEH SPECIFIED HERE• <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIODlS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTfiUCTION. . <br />SIUN�TUREOFCON7N�CTOHORAUTNOf11ZED�GENi O�TE <br />X 6�i- O !C - - --- - - "�- J'� - 3� R <br />oo��� <br />MECHF.NICAL <br />OR ITEM FEE NO. TYPE OF E�U�PMENT <br />A/C — �/HNOL6 UNITS — N P. <br />PEFRIGERATION UNITS — N P. EA. <br />BOILERS — B.T.U.MP. <br />6AS FIt1ED A C. UNITS — B.T.U. <br />FO�CED AIH SYSTEMS — B.T.U. M <br />WALL HEATEPS — B.T.U. M <br />UNIT HEATERS — B.T.� M <br />EVAPORATIVE COOLEPS <br />� CLOTNESOR�ER$ <br />VENTIUTION FAN <br />qANOEH000 <br />WATER NEATER <br />�5 WOOD STOVE <br />METRL FIREPLACE 6 CHIMNEV <br />FIREPIACE INSEflT <br />MEAT P4MP �� <br />GAS PIPING <br />E%HAUSTFAN _ <br />SUBTOTAL � <br />PERMIT f <br />TOTAL FEE _ <br />nlAnsEreAGrc 51[ <br />NO of <br />V�C�Nf 5�1L <br />OVES ON(1 <br />GB07P NOOFDWfI <br />eran ron issu�r+ce ar <br />lUeTOTAL <br />P[RMIT <br />TOTALFEE <br />PLANI:HECK NUMBER IFEE <br />PECEIPTNO.i .p; 1�,.�.' �� <br />.;' � �I,r� � <br />1.' <br />FEE.:I" i�� <br />- 5 � . ;li I' :.i:' <br />BUILDING �' <br />� i <br />. ' . f i'I �:�' . <br />PLUMBING <br />MECHANICAL . <br />t- <br />O7HER <br />�'� <br />STATE BUILDING SURCHARGE �' � <br />�--� � l <br />STATEENERGYSUPCHARGE ' <br />PUBLIC WORKS <br />TOTAL <br />PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMININO ALL J� � <br />PROPERN LIP�E LOCATIONS AND RELATED EASEAIENTS. . �• . <br />