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,APPLICATION FOIL <br />OTYOF <br />CaN rn.n CONSTRUCTION <br />Uf <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259.8810 TO BE COMPLETED IN INK • PLEASE PRINT <br />I I DEMOLITION [7 COMBINATION Q BUILDING ❑ MECHANICAL <br />\, rILN MAIL ADORLS5 CITY OP <br />r rh'' <br />owocr I lri��-LJ(�,� S_5. 3 err <br />4NG DEf. OR Of SIGNER MAI ADNGSS CITY !R' <br />EIULf.ONIr1AC1Of1 �/ MAII.1RIR <br />q'.;b __-- <br />GLNlIP— <br />ip ...n-l.. {%_ I ,:In I n11'1k //)6 ir,I, <br />iPLUMBINGCONTRALTOn AIU+ WRI+L S!. <br />rel <br />PLUMBING ❑ SIGN <br />runrR <br />t, W.6". IYdo� <br />f"101% <br />PDONI 4 ]7 71 f y <br />- JJi1Y 7Arf,'rr/5q <br />IY ION[ ' I I kNSL <br />G <br />CIASSOF WORn ,-,� <br />❑ NEW ❑ ADDITION 17 ALTERATION <br />❑ REPAIR ❑ DLMOLUION ❑ WOODSTOVEIFRPLINSERT ❑ BUILDING RELOCATION <br />VALUATION OF YYOnh COST Or MIGLMAI S PI US I AI <br />-)-,f <br />J, <br />I <br />ob <br />Q_ <br />00 <br />LO <br />w OF ERDRu; ° /\ <br />HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />t <br />[Ott <br />PLICATION ANOKNOWTHE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONSOF LAWSAND ORDINANCES GOVERNING THISTYPE <br />II tGAI nESCRRVION OF PROPERTY 15110WN BELOW FACT+ INN COPIF SI <br />OF WORK WILL BE COMPLETED WIT( I WHETHER SPECIFIED HERE- <br />NOC�O' <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />LOI__ <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 />SIGNAIIIRL 01 I.01411 A11011011 AUNIONIIEO GENTOAH <br />x ��J i /> lJZ• ��� L�10 �/ <br />--- <br />�i <br />APPI IF.•f1T'S llfly IIII!,r,155 I II1T IIIiE NO <br />PRO N.cT Annnks5 <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />_I <br />ACC- AAINOLG UNITS -11P <br />REFRIGERATION UNITS LIP EA <br />BATHTUB1 <br />LAVATORY IWASH BASIN( <br />BOILERS - 0 f ll III P <br />----- <br />GAS FIRED A C UNITS -BT11 <br />SHOWER <br />N <br />FORCED AIR SYSTEMS - 0 T U. M EA. <br />KITCHEN SINK A DISP <br />_ <br />-_ <br />WALL (HEATERS -BT11 M <br />DISHWASHER <br />HHH' HEATERS - B T U M <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />CLOTI LES DRYERS <br />URINAL <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DRAIN <br />RANGE HOOD <br />BACKFLOW PREVENTERS <br />WATER HEATER <br />ROOF DRAINS - RAINLEADERS <br />WOOD STOVE <br />SINK (SERVICE - BAR. ETC I <br />METAL. FIREPLACE A CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />_ <br />-- <br />- - <br />GAS PIPING <br />EXHAUST FAN <br />SUR TOTAL <br />f <br />SLID TOTAL <br />3 <br />PERMIT <br />f <br />PENMIT <br />3 _ <br />TOTALFEE <br />3 <br />TOTAL FEE <br />r'1 AH CFIECK NIIMOEH <br />FEE <br />RECEIPT NO <br />RLAIi RLIBM)K ------ <br />SIDE SLTBACK <br />RUN( SE IDACh <br />NSE ZONE <br />IOF AREA <br />VAGANI Sill. <br />FEES <br />VALUATION <br />FEE <br />g <br />/ LI <br />LIVES IING <br />0111LDINGon <br />FYPC OF CONST <br />OCCUPANCY GROUP <br />NO OF DWTlI1N6IRIITS <br />PI 1IMBING <br />-- _ <br />_ <br />SIZE OF BIDG <br />NO OI 5101111:5 <br />MAX OCO 1 OAD -- - <br />MECHANICAL --- <br />OTHER <br />STATE 13UILDINLI SURCHARGE <br />J <br />S <br />FIRE SPRINKLERS REQUIRED ❑ YES O NO _ <br />STATE ENERGY SURCHARGE <br />APPI L:gIDfl ACC BY <br />PI ANSCNECKED D\' <br />AI'PR FOR ISSANC.E BY <br />PUBLICWONKS <br />L <br />TOTAL <br />F fnN nFTFRMINING <br />ALL <br />l <br />rn". r\I I V..I. g nu.-.-....--- _.._. _. <br />PROPERTY LINE LOCATIONS AND RELATED EASEMENTS. <br />