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the EYerpreen <br />CITY OF <br />everett <br />BUILDING DEPT. <br />259.8745 <br />`APPLICATION FOk,' <br />CONSTRUCTION <br />PERMIT <br />TO BE COMPLETED IN BLACK INK- PLEASE PRINT <br />❑ COMBINATION ❑ BUILDING ®. MECHANICAL <br />NOV 25 <br />......... <br />...................... <br />CITY OF EV T f <br />❑ PLUMBING ❑ SIGN <br />R MAIL ADDRESS CITY ZIP PHONE FIt ENSE <br />GENERAL CONTRACTOR O imp Mt1C_U-iA/T <br />C c <br />CITY <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />CLASS OF WORK [I <br />❑ NEW 6 ADDITION Cl ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVElFRPL.INS� RT BUILDING RELOCA710N <br />VALUATION OF WORN (COST OF MATE RIALS PLUS LABOR) <br />Al 5 2_5<=) <br />DESCIUDE W RR " <br />ACK> 1 wl\ti lac- J.I " <br />USE Or BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />6)c-c c,_ <br />PLICATION AND KNOWTHE SAMETOBE TRUE AND CORRECT. ALL <br />PROVISIONSOF LAWSANO ORDINANCES GOVERNING THIS TYPE <br />LEGAL DESCRIPTION OF PROPERTY( SIIOWN BELOW OR ATTACH FOUR COPIES) <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE- <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />LOT_SLOCK_.—OF <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANYOTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNAT OF CONTRACTOR OR AUTHORIZED AGE NT DATe <br />PROJECT ADDRESS <br />APPLICAN CITY BU5INESS LICENSE N' <br />3 0 %<rl. o,AC <br />8oa� <br />MECYANICAL -- <br />FEE <br />PLUMBING <br />NO.E <br />TYPE LF FIXTURE <br />FEE <br />NO. TYPEQUIPMENT <br />ET (TOILE <br />AIR COND. UNITS-H.P. EA <br />REFRIGERATION UNITS-H.P. EA.ASH <br />BOILERS-H.P. EA. <br />BASIM <br />GAS FIRED A.C. UNITSK <br />FORCED AIR SYSTEMS-B.T.U. M EA <br />6 DISP. <br />WALL HEATERS-B.T.U. M <br />LAUNDRYTRAY <br />- UNIT HEATERS-B.T.U. M <br />CLOTHES WASI4ER <br />__ EVAPORATIVE COOLERS <br />WATER HEAIER <br />_ONFAN <br />VENTILATION FANUNTAIN <br />RANGE HOODN <br />AIR HANDLING UNITEAKERS <br />STOVE <br />S-RAINLEADERS <br />METAL FIREPLACE8E-BAR• <br />WOODSTOVEIFIREPLACE INSERT <br />MURINAL <br />ETC. <br />i wAcz,v �(Q LE/Xl1�U� zTou� EJo <br />SUB 1 OTAL <br />SUB TOTAL f <br />PERMIT S <br />___ PERMIT <br />3 <br />OJ <br />__ <br />TOTALFEE �_ <br />_ _ TOTALFEE <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />