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th� EvuOrnn <br />cm oF <br />everett <br />BUILDING DEPARTMENT <br />259-8810 <br />�-�PNLICAI"ION FO`.� <br />CONSTRUCTION <br />PER10�11�' <br />TO BE COMPLETED IN INK- PLEASE PRINT <br />❑ DEMf1LITION ❑ COM8INATION ❑ BUILDING ❑ MECHANICAL ❑ PLUM8ING <br />' o� <br />.✓ <br />everen <br />� <br />❑ SIGN <br />�� G EfUL COMFACIOfi M/IL �[1D11E55 Cliv �1P OIiON[ LICENSE • I <br />' �����i <br />1 MECNRNICALCONiRACiOq 6�nI�RU�RE55 CitY ZiP PHONE LICENSE• <br />. PLUMOMaCONiPALIOF h1All.�p�RE55 CIIY I�P P�IONE LICENSE• <br />1 CLASSOFN'ORN �I <br />? ❑ NEW ❑ A�DIiION ❑ ALTERATION �REPAIR ❑ OEMOLITION ❑ WOODS70VE/FRPL.INSERT ❑ BUILDIIlG RELOCATIOM ; <br />VA�UATION O� WOR✓ If.051 O� A141ERNL5 PlUS LAfiOfll � <br />' ✓ ?��.OL -�1cllVlf.l �l���. " �1YlC�bW�; -�" �Q�-bf� ' ���L�� i <br />� <br />✓ <br />✓ <br />�or_ <br />� <br />C <br />I HEREBY�CERTIFY THR�-( HAVE READ AND EXAMINED THIS AP- ' <br />PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL � <br />PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE . <br />OFVJORKWILLBECOMPLETEDWITHWHETHERSPECIFIEDHERE- � <br />IN OR NQT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE �UTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAI. LAW REGULATING CONSTRUCT::JN <br />OR TH ERFORMANCE OF CONSTRUCTIOf�. <br />SIGH�7ll E�O/ CONiRACiOR OR FUiNORIZE� AGENi O�TE <br />PROJECT 400RE55 ACPlif.nN �5 Qirv [IUSuiE 55 ��CEnSF. ��O <br />✓ �,?03 �-4��/l SI �VC'l�'_�f� �c�ZO � � <br />PLUMBING <br />NO. <br />OR ITEM <br />WATER CLOSET �TOILET) <br />BATHTUB <br />LAVATORV�WASH BASIN) <br />SHOWEH <br />KITCHEN SINN 8 OISP. <br />DISHWASHER <br />LAUNDNVTRAV <br />CLOTHES WASHER <br />URINAL <br />ORINKING FOUNTAIN <br />FIOOR DRAIN <br />6ACNFLOW PREVENTERS <br />ROOF OR�iNS — RnWlEA0ER5 <br />SINK �SEH:�CE - BAR. ETC � <br />rnoNrsemncK <br />use znNe <br />i <br />. PVPI.I�Ai1011 AGL OY <br />SUBTOTAL <br />PERMIT <br />TOTALFEE <br />nenn sEroacK <br />/iIER <br />StORIES <br />JPCRNI SIIE <br />❑vES ONO <br />iUP NO OG OWELLINO UNIIS <br />MAX OLC IOAD <br />❑ NO <br />nr nvvnron�„u�uccnr <br />MECHANICAL <br />NO. TYPE OF EOIJIpMENT <br />A/C — A/HNULG UNITS — H P. <br />REFRIGERATION UNIT$ — HP. EA. <br />0011EP5 — B.T.UIH P. <br />GA$ PIRED A.Q UNITS — B T.U. <br />FOFCED AIR SYSTEMS — BS.U. M EA. <br />WALL HEATERS — d.T.U. M <br />UNIT HEATER$ — O.7.0 M <br />EVAPORATIVE COOLERS <br />CLOTHESDRYERS <br />VENTILATION FAN <br />RANGEMOOD <br />WATE(1 NEATEF <br />WOODSTOVE <br />MET�L PIREPUCE S CHIMNEV <br />FIREPLACE INSE(7T <br />HE�T PVMP <br />GAS PIPING <br />E%HAUSTFAN <br />SUOTOTAI <br />PERMIT <br />TOTAI FEE <br />�'LnN CHECK NUMDEfI I FEE <br />FEES VALUATION <br />BUiLDING S <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BUILDING SURCHARGE <br />STAiEENEHGYSURCHARGE <br />rueuc wor�Ks <br />TOTAL <br />) C"�-o�C�' - U <br />FEE <br />RECEIPT NO. <br />fROPEF7i1' OWNERS ARE RESPONSIBLB FOR D[TERMINING ALL <br />Pf70PERiY L W[ LOCAiIONS AND RELATED EASEMENTS. <br />