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„.PPL�CATION F01. ���,�„ <br />'"'E"'"°'”" CONSTRUCTION <br />un oF � <br />everett PERMIT <br />BUILDING DEPARTMEtJT <br />269•9810 TO BE CQMPLETED IN INK - PLEASE PRINT <br />❑ DEMOLITION O COMBINATION � BUlLDIPJG 6A MECHANICAL ❑ PLUMBING D SIGN <br />L� <br />pµq�p M�q �O�RE55 CITY ZIV PNONC <br />��I�)DrJ ��STg,G,ri,r��, �`�a� �4� aJ�_ ;�:. rdt.,�F.�i u�/� '3•>3_�llt�\ <br />�RCNRECIOROFS�ONER M�IL�pORE55 CITY ZIF PHONE <br />�ENEA�LCONIR�LIOA M�I1�00�E55 CiIY LP �uOHL uCE4SE• <br />�'.0 �-r�J A IC �• f?�z.z. �ur=_ ►�t� � ff � �nr�Tv�l v'� � E. i,�,.t QSz--r�r,3 ;n t i itl4cr� Pil <br />�tWAB�NaCONIR�GIOA MMLAppRE55 CiIY 21f` PIIONF �ICf�I"•E• <br />CL�SSOf WOPe <br />❑ HEW ❑ �DDITION <br />� Y�W ��Or�orwOn.�Ca510�G: <br />1 `-� `� SDU <br />� u[z e[ v�onK <br />; �-r PI.Ac_ � C��'— F' �� eJ!+,c.r <br />7 ALTERAiION ❑ REPAIR ❑ DF.MOLI710N ❑ WOODSTOVE/FRFL.INSEFT ❑ BUILDING RELOCnfION <br />IEd�L �ESCRIGl10N U� �ROPI <br />ioi—e�ocK—or <br />C� �•�' 1 Q c 7 (,� <br />R VISNOWNDELOWON�IUGNiOUP <br />�.�� ���,1 �� ti5 F�,�z N A�C: <br />1 r I IiEREBY CERTIFY THAi 1 NAVE READ AND E%AMINEO TI115 AP� <br />14,`�•�`,`�''t�" pLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL <br />PROVISIONS OF LAWSANb ORDINANCESGOVERNING THIS TVPE <br />OF WORK WIIL BECOMPLETED WITH WHETHER SPECIFIED H[RE• <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME 70 <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANV OTHER 5�ATE UR LOCAL LAW FEGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. p <br />SIGNAIURE OF CONfR4CIOR OR AUTHOIi12ED A6ENT OaiE ���'� � � I� J <br />/ 1 <br />�L-G. � GR� �i'�i�� <br />�PPLI(:ANTS CItY PUSINESS IICENSEN <br />�q�%� <br />! PAOJEf,110DPE55 <br />'� �i�e`� io �, If, A• i._ Si_. ���t`_Q;i �-� <br />VLUMBIN6 <br />NO. TYPEi <br />�1FE : UNE <br />na <br />WIITER CLOSET �TOILET� <br />BATHTUB <br />LAVATORY�WASH8451N� <br />SNOWER <br />NITCHEN SINK 6 OISP <br />' DRAINS —R�I�lL6�DERS <br />ISERVICE — BAa. ETC 1 <br />MECHANICAL <br />FEE <br />A/C — A/HNDLO UNITS — H P. <br />NEFRIGERATIONUNIT3—H.P. EA. <br />BOILERS — B.T.0 /H.P. <br />CAS FIRED A.C. UNITS — B.T.U. <br />�ORCED nIR SYSTEMS — B.T.U. ;. <br />l4ALl HEATEiiS — B.T.U. <br />UNIT MEATERS — B.T.U. <br />VENiIIAitON FAN <br />. HANGEHOOD <br />WATERHEATER <br />WOODSTOVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACE�NSERT <br />HrpiPUMP <br />GAS PIPING <br />E%NAUSTFAN <br />SU! TOTAI f <br />PERMIT f <br />TOTALFEE f <br />N SE �BACM SIDE SETBACN <br />A���'� VRC�NTSIfE <br />❑YES pN0 <br />�IPn11GYG0pUP NOOFOWfLLI4GlINItS <br />Nn ur ston�es I MR% <br />m; <br />er <br />SUeTOTAL <br />� <br />� <br />� TOT�LFEE f� <br />i�1.AN I;MECK NUMBEH I FEE I RECEIPT <br />FEES ' <br />BUILDING S <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BUIIDING SUFCHARGF. <br />$TATEENERGVSURCHAHGE <br />PUBLIC WORKS <br />TOTAL <br />PROPF.RTY OWNERS ARE RESPONSIBLE FOR OETERMINING ALL <br />PROPERTY LINE LOGITIONS ANU RELATED EASEMENTS. <br />