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L <br />fhrEvupnen ' .:'APPLICA►TIQ►N F(,.,� <br />��TM�F CONSTRUCTION <br />everett PERMIi <br />BUILDING DEPARTMENT <br />259•e�a5 TO BE COMPLETED IN INK • PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL I� PLUM9ING <br />everetl <br />� <br />❑ SIGN <br />CONIR�CIOR MRILAOORE55 CITY ZIP PHONE LICENSE• <br />LIP <br />PLOIABINGGOHIRACtOR MAILAUpRE59 CITY ZIP PHDNE LICENSE• <br />ScnPr-�2zv/L Pcc��M.B�-NG� y�/o zzt s� S,W, MrC,� 7�,rk �,�ov3 ��G-aA2y ,�f.��,���c-, <br />cuss or wone <br />I� NEW ❑ AD�ITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOO�STOVE/FRPL.INSERT ❑ BUILDING FELOCATION <br />Vs�URiION OF WOfIK � W SI OF MRtEf11A15 PlUS LABOIp <br />oF <br />�eaai oese <br />�or_ <br />seroncK <br />USE <br />ttPE <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAAIINED THIS AP• <br />PLICATION AND KNOW TH E SAME TO BE TRUE AN D CORRECT. AL L <br />PROVISIONSOF LAWSAND ORDINANCESGOVERNINGTHISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE- <br />IN OR NOT, THE GRANTING OFA r'ERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL lAW RE �ULATING CONSTRUCTION <br />OR TH �ERFORMANCE OF CONSTpUCTION. <br />SIONATU Of/�ONTflACTOR OR AUTHORIZEO AGEf�T UATE <br />VTb CITY BUSINE53 LICENSE N0. <br />1N��A� <br />TYPE OF EOUII <br />AIR COND. UNITS—H.P. EA <br />flEFRIGERAi'ION UNITS—H.P <br />601LERS—H.P. EA. <br />GAS FIRED AC. UNITS—TONI <br />FORCED AIR SYSTEMS—B.T.1 <br />WALL HEAiERS—B.T.U. M <br />UNIT HEATERS—B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRVERS <br />VENTILATION FAN <br />RANGEHOOD <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />NO. OF StOf1IE5 <br />YACFNT SITE <br />DYES ONO <br />NO. OF pWELLINp UNITS <br />FOR ISSUFNCE BV <br />BUILDINO <br />PLUM6IN� <br />MECHANICAL <br />OTHER <br />PENALTY <br />TOTAL <br />� <br />FEE RECEIPTNO. <br />FEES VALUATION FEE <br />S <br />;r•.._�.:. .. . , .. . . �:�. � . . . � � .... . � . <br />