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`�-;PPLICATION FO� � �°� °f ��YK�n <br /> �^.E~ro�»° CONSTRUCTION E1 <br /> �,,.oF � y s�a 7 <br /> everett PERMIT �,5� <br /> BUILDING DEPAFTMENT TO BE COMPLETED IN INK- PiEASE PRINT � <br /> 259-8810 <br /> ❑ DEMOLITION O COMBINATION ❑ BUILDING O MECHANICAL ❑ PLUMBING ❑ SIGN <br /> (M1M1IL AD/O�AL�^55 / / /GIIY 21P FHOHE <br /> O��NJ.� I•�1 �YJ I�T� �/�I�l�\ ��In ��IX GVF� Zp , �IONE '�� <br /> tnplaf[L�UA�IS�G��fR MnIL/.D�AE55 <br /> M�II ��U�C55 CITV lIP �'PONE UCEYS!• <br /> Gf��C1UL CONtR�GIOA „�� n''+.� <br /> ,rnr_�-: L�N,ST. (��. 42JSi /� �J L41�Wa�� �rs..i��p 77S-SS�L �-ES=7LZ35/�, <br /> M�IL�DORE59 Clrv IIP �I�ObE CC [ <br /> r��Cw�.lT.�l COi��w���nq <br /> �LUMB�NO CONiR�LiO(1 <br /> MML I.00RE55 GIIV 21^ PNONE IICfHSE� <br /> CUSSOf WOaM <br /> ❑ NEW ADOITION ❑ AL7ERnTION ❑ REPAIF ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT BUILDING AELOCAIIO�� <br /> �.�u.��oNorwom�cos�r/�'r�Mi[nu�srlusuHOfk <br /> (I • / �'�/' <br /> � �� � <br /> OFSGp�BLwOPR � r^ ^ � <br /> L1MIrlC, �.ir��.> _ - — � i �- �''� <br /> utt or vuoroc I HEREBY CEflTiFY THAT I HAVE READ AND E%AMINED THIS AP� <br /> �� �ny �'���(� PLICATIONANOKNOWTHESAMETOBETRUEANDCORNEGi.i�Ll <br /> IEGLLDESCRI�➢ONO�OAOPWI�ISHOWHBROWOA�ITAGNfOURCOPE51 PROVISIONSOFLAWSANDORDINANCESGOVERNINGiHISTVPE <br /> OF WORK WILL BE COMPLETED WITH Wl1ETfiER SPECIFIED HERE• <br /> Lo _Bio��_a� IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIOMS OF <br /> ANY OTkiER STATE OR LOCAL LAW REGULATING CON57RUCTION <br /> OR THE PERFORMANCE OF COtJSTRUCTION. <br /> 516NRTUAEOFGOYiF�CTGNORAUiNO�i�2E�RGCNf 0/•TE <br /> f S7a � A- � ` �'� 8'7iT U� <br /> Z��O � APP�IO�N 5 I�Yp 51 SSl�ENO <br /> PROJCGI�ODnE55 <br /> .�--I ���Cllt�cc_'�\ <br /> MECHANICAL <br /> PLUMBING FEE <br /> NO. <br /> TtFE OF F�fITURE OR ITEM FEE NO. T'PE OF EOUIPMENT <br /> AlC—A/HN�IG UNITS—MP. <br /> W�TfR LLOSET�TOILETI <br /> REFHIGEPATION UNITS—H P.EA. <br /> BATHTUO <br /> BOILEPS—B T.0 MP. <br /> LAV�TOAYIWASN BASINI <br /> GAS FIRED A.C.UNITS—B.T.U. <br /> SHOM/ER <br /> FORCED AII?SYSTEMS—BS.U. M EA. �_ <br /> 1(ITCHEN SINK b OISP. <br /> WALLHEATERS—B.T.U. M <br /> DISHWASMER M <br /> UNIT HERTERS—B.TL. <br /> LAUNORYTR�Y <br /> EVAPORATIVECOOLERS <br /> CLOTHES W/SHER CLOTHESORVERS <br /> URINAL <br /> VENTILATION FRN <br /> DRINKING FOUNTAIN AANGE 1100� <br /> FLOOA�RAIN <br /> WATER NEATER <br /> BACKFION PREVENTE�S WOO�STO�E <br /> nOOF DAA�NS—AAINIEA�ERS <br /> SINN�SERVICE—BAR,ETC) MFTAL FlREPi.ACE 8 CHIMNEV <br /> FIREPIACE INSEHT <br /> HEATPUMP <br /> GAS PIPING <br /> E%HAUSTFAN <br /> SUBTOTAL <br /> SUSTOTAL f <br /> PEpMIT <br /> PERMIT s <br /> s TOTAIFEE <br /> T0T11L FEE <br /> ' %.AN I:MECK NUM9EH FEE RECEIPT NO. <br /> �uUN�^vE�O�Cx �[PNSEIB�CK SIDESEtB�GN �� ���� (�i/ �� p�y/+'7� <br /> D �(/c0,�'i <br /> usEt��E io+�nes FEES VAWATION FEE <br /> VAC�NT Sif[ <br /> � L a.es or+o r- <br /> BUILDING S �W <br /> f�n[pfr[ON51 OCCUFRNLYGROUP NO.OfOWFlLINOUNIiS <br /> �� /y/Z � - Z � PLUM�ING <br /> �ip�7�Qi pp Hq a-5ton�ES M�K oCG lo�o MECHANICAL <br /> /f�1�1 r74t/B tS / %%'i� <br /> .�/ OTI/ER 2 <br /> FIRE PRINHLERS REOUIRED ❑YFS A NO S7ATE BUILDING SURCHA(iGE ,J S <br /> STATEENENGVSCRCHAFGE <br /> <rr�i¢xtio�+�cr, a� i'V�+sCUECKEOBr ��Pq.i0RI55U�NCE6Y pUBLICWORKS <br /> `n 1/ u^ %� L C TOTAL <br /> V��� 1�1 <br /> PROPERTY OWNERS ARE RESPONSIBLE�OR DETERMINING ALL <br /> PROPERiV LINE LOCATIONS AND RELATED EASEMENTS. <br /> ,•r <br />