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i <br /> APPLICATION FOh-' � <br /> '"'E"`°`"" CO N STR U CT I O N °°`�`„�`" <br /> ��r o� <br /> everett PERMIT <br /> BUILDING DEPARTMENT <br /> 259•8810 TO BE COMPLETED IN INK- PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING O MECHANICAL ❑ PLUMBING O SIGN <br /> OW��E� MeIL�OD11E55 - GI1V 21P FnONE <br /> ..jiJ i.-i F_ �' ���i�ia T�l S 7� �i - 7:L " _ a i �v e.t �/%Gl.:, �s A i o 1 :1 5�5--G .f—�/�j <br /> •nCNlflQOnOFS�G�rtR M�IL�DORGS$ UiY 21w Pr10NC <br /> ❑l��fPltfONtM�tO�s��`I��Ly'� MML�OOOE55 CIfY [IP CHONE LI[EiRE• <br /> �I^r� J 'C�C�- — <br /> IALb�.1NiUt LONIR�CIOq M�IL�OOf1E5S CIIY 21P PIIONE UCENSE• <br /> FWIlP�NOCONIO�Q011 MAIL�ODRE55 pfV 2iP ViIONE <br /> IICENSE• <br /> GLA55Of WU11v. <br /> ❑ NEW ❑ nDUITION ❑ ALTERATION C� REPAIR ❑ OEMOLI110N ❑ WOODSTOVE/FFPL.INSERT ❑ BUILDING REIOCnT�ON <br /> v� nuNarWOnr�f,p51o11.uil.nuL..rWSUAnN <br /> �7sn <br /> oau�ret wonn �/ <br /> � i�v /' i C= /�I t <br /> USf O� JII I1�IIG <br /> 1 HEREBY CERTIFY THAT 1 HAVE FEAD ?Nn EXAMINEO THIS AP� <br /> � " ^� � � � r PLICATIONANDKNOWT4ESAMETOBEiqU�ANDCORRECT.�LL <br /> l[O4(1f5CA��11pNOtPqOFEtllv�g110WNBELOWOA�1fACMipU�COP1E51 pqpVISIONSOFLAWSANDORDIN�NCESGOVERNINGiHISTVPE <br /> � OF WORK WILL BE COMPLETFD WITH WFiETHER SPECIFIED HERE• <br /> ioi�oioc�_or . IN Ofi NOT.TNE GRANTING UF A PERMR DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIOPlS OF <br /> ANYOTHER STATE OR LOCAL LAW REGULATING CONS?RUCTION <br /> OR THE PERFORMANCE OF CONSTRUC710N. . <br /> SIGN�IURE OF CONIRRCIOR OR AUf110f112E0 AGCNT p0.7E <br /> a 3 � _,, � X �����i-�5=�� <br /> PHOJEC1�pORE55 �PPLIL SCIIYBUSINESSl4[IISENO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATEA CLOSET�TOILET� AiC—AiNNOl6 UNITS—H.P. <br /> BATHTUA HEFRIGEP�TION UNITS—HP.EA. <br /> L,NVATORY�WASN B�SINI DOILERS—B.7.U./N P. <br /> SHO W ER GAS FIRED A.C.UNITS—B.T.U. <br /> NITCMEN SINK 8�ISP. PORCEO AIR SYSTEMS—B.T.U. M EA. <br /> OISHW�SNER WnLLHEATEfiS—B.T.U. M <br /> LAUNDRVTRAY UNITHEAiEi75—B.T.0 M <br /> CIOTNES WASNER EVAPORATIVE COOLERS <br /> UF�NA� CIOTMES DRYERS <br /> DAINNING FOUNTAIN VENTILATION FAN <br /> FICOR O�AM qANGE MOOD <br /> B�CKFLOW PPEVENTEfiS Wq7ER HEATER <br /> ROOF DFAINS—RAINIEADERS WOOD STOVE <br /> SINN�SERVICE—BAR.ETC� METAL FIREPLACE 6 GHIMNEY <br /> FIREPLACEINSERT <br /> HEAiPUMP <br /> GAS PIPING <br /> EXHFUSTFAN <br /> SUBTOTAI f EUlTOTAL <br /> PEfIMIT f pEpMlf <br /> TOT�L FEE f TOTAL FEE <br /> '^���+�:FioeCr nf�n5[�O�CK S�U[5[ID�GK � �'�ANCNECKNUMBER FEE RECEIPTNO. <br /> us[.ur�e io�enee VALANf 51t[ FEES VALUATION fEE <br /> �YES ONO <br /> «�'COi�COqS� OCCW`PHCVG110UP NOOFDW[L4NOUNIIS BUILDING $ � � <br /> PLUMBING <br /> S�PEOfp�p� IIpU15IONE9 M�%.00C.t0�0 <br /> MECHANICAI <br /> OTHER <br /> FIPE SPRINKLEFS REOUIRED ❑VES O NO STATE BUILDING SURCHARGE � <br /> STnTE ENERGV SUI7CHnfiGE <br /> >fC�i(;LIIONRCf. B• PUNSCIIECKE�DY I'�PF11.fORt55WNCE0Y <br /> rueuc wonKs <br /> TOTAL t <br /> PROPERN OWNERS ARE RESPONSIBLE FOR DETERMINING ALL <br /> PROPEFTYLINE LOCATIONSAND RELATED EASEMENTS. <br />