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. s1 <br /> APPLICATION FOa �� ���,�„ <br /> ,".E"'°'"" CONSYRUi TION O <br /> �iTY OF <br /> everett PERM T <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK• PLEASE PRINT <br /> O DEMOLITIOW ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> M�II�DOPE55 LIIY Zp�P PnONf. <br /> /�Hi1�EG�OLS�ONEN � M�II/�O���� �I�� Jlf' ��'� PIION[ � � � /��� <br /> 'OEN��R�GIOR � /' M��t�OUII[iS C��� I��' �•�NIII IICLNSE• <br /> /// <br /> ��vQ <br /> MfCM�N��CON�N�G10 M�R�DIlNE59 Ulr !�P Pu04[ IICFNRf� <br /> RUMB'HL CONfp�ClOR M1M1 10CAE55 C�IY Itl' PHONI 1N;1.115!• <br /> G��SL Of WORn — <br /> ❑ NEW ❑ ADDITION ❑ ALTERAiIqN ❑ REPAIR ❑ DEMOLI110N ❑ WOODSfOVE/fRPL.INSERi ❑ �UILDING FELOCATION_ <br /> v��u�uoHo.\MBMIGO51 O�M�I[114L3 PLU3 UPORI <br /> DE9GA�BF NORe <br /> - �/�-�-d �-�-e <br /> U9E O�BNLO�NO • <br /> j �• , p„ � 11EREBV CERTIfY THAT I HAVE REAU AND ExAMINED iH15 AP� <br /> ��,ftM�T/—l.�' PLICATION AND HNOW THE SAME TO BE TFUE ANDCORRECT.ALL <br /> IEO�LDESGFim�ON0�1'POPERfYI5N9WNP won+rucr�rounconi�s� pqOVISIONSOFLAWSANDORDINANCESGOVEPNINGTHISTYPE <br /> OF WORK WILL BECnMPLETEO WITH WHETHER SPECIFIED HERE• <br /> ioi_eiot�—or_• IN OR NOT.THE GRANTING OFA PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIJLATE OR CANCEL THE PFOVISIONS OF <br /> ANV OTHER STAtE UR I OCAL LAW REGULATING CONSTRUCTION <br /> ---'�— OR THE PERFORMANCE OF CONSTRUCTION. <br /> SiGN�IUAEO CONtMC�OROf1�UiHOf1KED�GENI MfF <br /> --- --- X✓�7�7 i��.M'r(-:r�c.f' G—3 0-8� <br /> PPOJECi�pORCSS ���`UC�N�SCIIYpU51Nf5� if.fNS[NO <br /> ' PIUMBIN6 ��+— MECHANICAL <br /> NO. TVP[OF FIIlTi IR[OR ITI'.M FEE NO. TYPE OF EOUIf`MENT FEE <br /> W�tEP CLOSET ITOaE fl MC—MNNOLO UNITS—N P <br /> 011TNTUF NEFRIGEP�TION UNITS—1/P EA. <br /> :.AYATOPV�WASM B�SIN� IfOILERS—B T.0/H P <br /> SMOwER O�5 FIRED�C.UNITS—B T U <br /> I(ITCHEN uINK 6 OISP. F017CE0 AIR SYSTEMS—B T U. M FA <br /> DISNWASMER WALLMEATC�S—O.TU. M <br /> LAUNDNY TR�Y UNIT HE�TERS—BS U M <br /> CLOTHES WASi�ER EVAPORA7IVE COOLEPS <br /> URINAL CLOTNESORYEPS <br /> ORINNINO FOUNTAIN VENTILATION FAN <br /> FLOON OAAIII RANGE HOOD <br /> BACNFLOW IMIEVENTERS WATER ME�TER <br /> HOOfORAl1�S—HAINLEAOEHS M�OOOSTOVE � <br /> SINN�SERVIGE—B�P.ETC� METAL fIREPUCE R CMIMNEY <br /> FIREPUCE INSERT <br /> HEAT PUMP <br /> OAS PIPINO <br /> EkMAUSTFAN <br /> fU/TOT�L f ' tU!TOTAL <br /> ►ERMIT f ���T <br /> TO7�Lf!! f T0T11LFEE <br />� fNOMTSEis�te 11E�aSE�NSGK SiOElE1B�:• PLANCNECNNUMBER FEE RECEIPTNO. <br /> j USEIONI ����AE• v.ceHisia FEES VALUATION FEE <br /> OVE9 ONO <br />� fYPEO�CON41 OC�UP�NGY6RUUP NOO�UWElLIN6UN119 BUILDING S <br />� Pl.UM81N0 <br /> 1 84f Of BlDO NO Gf SIOA E9 M�%OCG LO�O <br /> 4 MFCH�NICAI <br /> OTNER <br /> FIRE SPRINKLERS REUUIqEO ❑ YE.S ❑NO STA7E BUILDIN6 SURCMAfiGE <br /> STATEENEROYSUFCMARGE <br /> I,VPLIC�IION�CCpY �L�NSCNECItEDB\� I1PPRfOR195U�NC1�.pY <br /> PUBLIC WORKS <br /> TOTAI <br /> PROPEii1Y OWNERS ARE RESPONSIBLE fOR�ETERMININQ�LL <br /> PROPERTV LINE LOCAilONS AND REIATED EASEMENiS <br /> r-'. Tm"n. ro.p.-�, � ..z. . n., •7Y't "�P ^f'!4'S1C:q•v.7�^.'. <br />