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LAP Ewrpmn <br />CITY OF <br />everett <br />BUILDING DEPT. <br />nen_a9AG <br />.PPLICATION FO►. <br />CONSTRUCTION <br />PERMIT <br />TO BE COMPLETED IN BLACK INK- PLEASE PRINT <br />n .. LIw I ,A M null DING ❑ MECHANICAL <br />❑ PLUMBING ❑ SIGN <br />PIIONE LICENSE . <br />PLUMBING CONTRACTOR MAIL ADDRESS <br />CITY ZIP <br />CLASS <br />V NEW ❑ ADDITION ❑ ALTERATION [I REPAIR El DEMOLITION ❑ WOOD9TOVE/FRPL.IN9ERT <br />[I BUILDING RELOCATION <br />OF WORM <br />VALUATION Or WORK I COST oryATERMLS PI US LABOR) c. CJ <br />Z <br />— V C) <br />CD <br />Oy <br />DESGRI WORK <br />CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />u9E or— auaolNo ,/"\ <br />I HEREBY <br />PLICATION AND KNOWTHE SAMETO BE TRUE AND CORRECT. ALL <br />.. .. <br />S GOVERNING THISTYPE <br />DWITH <br />�T <br />LEGAL DESCnIPT1oI FPPOPERTY I9NOWN BELOW A HrOURCOPIEq <br />OF WORKWIILLL13COMPLETED WHETHER SPECIFIED SPECIIFIED HERE, <br />OF�. U�XQD_ i " <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />PROVISIONS OF <br />N m <br />Lor... BLOCK__ <br />GIVE AUTHORITY TO VIOLATF OR CANCEL THE <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />mo <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />o <br />X - 5 <br />1Z <br />TT <br />APPU A rBCITYBUSINEBBLICENSE <br />C <br />PROJECT ADDRESS <br />q y <br />• <br />t <br />MECHANICAL <br />'� <br />PLUMBING <br />FEE <br />NO. TYPE OF EQUIPMENT FEE <br />T <br />N TYPE OF FIXTURE <br />AIR COND. UNITS—H.P. EA. - <br />T F <br />y3 <br />WATER CLOSET TOILE _� <br />REFRIGERATION UNITS—H.P. EA <br />...I f�I <br />BATHTUB <br />BOILERS—H.P. EA. <br />_ <br />m .- <br />LAVATORY WASH RASI <br />_ GAS FIRED AC. UNITS —TONNAGE EA <br />N <br />� <br />SHOWER <br />FORCED AIR SYSTEMS—B.T.U. M EA <br />r <br />R' <br />KITCHEN BINNS 019P. <br />WALL HEATERS—B.U. M <br />N <br />_f <br />1 DISHWASHER <br />UNIT HEATERS—B.lU. M <br />LAUNDRYTRAY <br />EVAPON.TIVE COOLERS <br />CLOTHES WASHER <br />I CLJTHE9 DRYERS <br />A m <br />1 I WATFR HEATER _ <br />G 00 <br />A <br />TUIQ CnDTInN Tn RF COMPLETED BY BUILDING DEPT. PERSONNEL <br />