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A. PLICA.TION �OR <br />�^. E°.�°�N° C O N ST R U C� 1 O N <br />Cltt OF <br />everett PERivli�' <br />BUILDIIJGDEPARTMENT TO BE COMiPLETED IN INK- ?LEASE PRINT <br />259•8810 <br />O DEMOLIT�ON C] COMBINATION ❑ BUILDING J ANECHANICAL <br />_------_ r.rtv nr <br />❑ PLUMBING <br />evcren <br />� <br />❑ SIGN <br />.nr.�urcr,i oa oesinr+en <br />nun eunacss cnr n� minm <br />_ .... .,,,,..�� ucni=� • <br />GEN[IIA'.GONINc�on M^11 �r� <br />v <br />rntauH�r.�� unnn�r.mq M�u �uonr.ss <br />r.nr zu� rnni.i. ucv�si . <br />�WMOIII�ICO\!I1��.IOR IAMIPf)OIII'i:i <br />CIIY lll' 1'110111 III I11'.I • <br />CU55 O� �'/OAw <br />❑ NEW ❑ �DDITION ❑ �ITERATION ❑ REPAIR ❑ [7GMOLIIIGN ❑ WOOf1510VElFRFL..INSERT (ll11LDING RELOCnIIOPI_ <br />v�tUAt�oNUfWonn�CoSio�r.�a�t���ai5rU�5l�ooR� � <br />USE <br />OF <br />ioi— <br />lO�--ll b — � <br />PLUMBING <br />Np, TYPE OF FI%TU <br />WATER CLOSET�TOILE7� <br />BATHTUD <br />LAVATORYIWASM Bn51Nl <br />SHOWEF <br />KITCHEN SINK A DISP <br />DISHW/SNER <br />LAUNDRYTflAY <br />CLOTH[5 WASI�EH <br />UflINAI <br />ORINNING FOUNTAIN <br />FLOOR DRAM <br />BACNFLOW PREVEtliEnS <br />ROOF DRAINS - �AINLE! <br />SINN ISERVICE - ���. El <br />�nUNI5E1p�Cn <br />SRE 0� Ol Dti <br />/N <br />OHI <br />u <br />SUBTOTAL <br />PE�MIT <br />TOTALFEE <br />n6�n sHOAcn <br />ioiancn <br />OILIIPAIlCY L!1( <br />Na nr s�o�u[5 <br />icaoa <br />FEE <br />I HERLBY CERTIFY THAT I I-IAVE READ AND EXAMINED Tlll;i 11P� <br />PLIC�TIONANDKNOWTHES�METOBETRUEANDCOFlRECT All <br />PROVISIONSOF LAWSANDORbINANCESGOVEHNING 7t11S 1YPE <br />OF WORK WILI. BEGOMPLETED WITII WIIETfIEFlSPECIFIED II[RE� <br />IN OR NOT. TFIE GRANTING OF A PERMIT DOES NOT PRESUP�tE TO <br />CIVE AUl IIOHIIY TO VIOLATE OR CANCEL TFIE PROVI5101J5 Of <br />ANV OTHER STATF OR LOCAL LAW PEGULATINGCONSTRUCTION <br />OR iHE PEFFORIdANCE OF CONS1fiUCiION. <br />sic�miur�Eorcuurnacrcrioi aun�onaFy -o�cc�� n.��� �5/Qg <br />X�/'// %a., ��.�NAi.�14./i_�,(/i�- <br />prP� �f.41+I'ti Cllv n��5�rvE5s 1 i[tpS[ <br />MECHANIMI. <br />Np TYpE OF EOUIPMENT <br />piC - NI IHI]LC UNITS - H P <br />PEFRIGEfi��ION UNITS -!1 P EA <br />OOILFfiS �- 0 T U�I � F <br />GASFIf1ED�C UNITS-OTU <br />FORCED �IR SVSTEI•15 - 8 T U <br />WAI.I. IIE�7 EflS - B T U <br />UNIT IIEPTERS - 0 T U <br />EVAPOIIATIVE COOLERS <br />CI.JT11E5 Uf1YE�S <br />VENTIIATION FAN <br />qANGE � �n00 <br />WATER IIEATEfI <br />WOO�STOVE <br />IAE�AL FIREPLACE 8 CFIIMNE� <br />fIREP1.ACEIHSERT <br />11EAT PUMP <br />GAS PIPING <br />E%IIFUST FAN <br />3 SUBTOTAL <br />f PE�MIT <br />— TOTAL FEE <br />f <br />sio[5[�nar,K ��'���NLFIECKNUM�ER IFEE <br />VACAHf SIIL <br />IIYES �IlIU <br />NO 01 U WI t I INii Urll l S <br />unx or.c innn <br />FEES <br />❑IIILDING 5 <br />PI.UMF3ING <br />MEC�iANICAI. <br />OTNER <br />FIRE SPRINHLERS REOUIREU ❑ YES ❑ NO � STATE BUILDWG <br />STATE ENEFl(iY SURCHARGE <br />a�,�.i���ii���q�:r m i�iA�iSa�ELnEoer InaPn rnnis5u>i+cEar ' pUBLICWORKS <br />M EA <br />M <br />M <br />FEE <br />FECEIPT NO <br />FEE <br />TOTAL � 1 <br />PPOPERiYLOINELOCAilONSA �rFSELA7EDE SEMF.NTSING�LL <br />