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I��Ewrqrwn ' PPLICATION FO: <br /> ci`r oF � everefl <br /> everett cONPERMITT�ON � <br /> BUILDING DEPARTMENT <br /> 259•8810 TO BE COMPLETED IN INK• PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDINfi ❑ MECHANICAL �PLUMBING O SIGN <br /> OWqEP M��l�OOf1E55 <br /> P�oP�na ��o0e►� `�yc� Po ha,c 107`�� c' qgl"'2� -- <br /> nc�re Uq b i�o0�[ss ��� <br /> z�P FHONE <br /> OkNEP1lCOHIRACIOB � M�1�Op� ��� �� �� bP OpON! <br /> �� ����� - O� � ���L�CENSE• <br /> io�v <br /> MEL �HIC�ICONIO� fOq M�ILAODflES$ �� <br /> =�P PNONE IiCEN9E• <br /> PLUMBIHaCONIpALIOq � / �O ��/`/, � CIIY <br /> /I .i. _./i�lf. i _ yr-� �TILE �R'/25� P"�M[k/ <br /> N iri�i.vri�i uctr�sr.. <br /> J•�LAIIY q fV <br /> CU55 iWOnM ��— ����� <br /> ❑ NEW �I ADDITION ❑ ALTERATION ❑ REPAIq ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSEI7T ❑ BUILDING RELOCnTiOt� <br /> V W TONOfWO� COSIOfM�IEH�l6PW9L�BON <br /> Of 9CRipL WORn • <br /> � r� -- <br /> uzr ar nuunw. <br /> ������ �a p�M I HEREBY CERTIFY THAi I HAVE READ AND EXAMINED THIS�1' <br /> �ca��oe IliPiiOHO�PROPEfl1Y�9nOWN �o II�ITACnidIpCOPlE9 P�ICATIONANDKNOW7HESAMETOBETRUEANDCORRECT.A(.L <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYF�[ <br /> �o�_eiocK_or OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE� <br /> IN OR NOT.THE GRANTIN60f A PERMITDOES NOT PRE�UME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISICtJS OF <br /> ANYOTHER STATE OR LOCAL LAW REGUTATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SION OiCONTN ipqORAUI110RIZC0�GENT O�IE <br /> PPOJECf�00RE85 API�UC�Nt5GiY8U5WE53L�CEN NO �� � <br /> .�c.� � z �� <br /> PLUMOING MECHANICAL <br /> NO. TYPE OF FI%TUNE OR ITEM FEE NO. TYPE OF EOUIPMEN7 FEE <br /> WATBR CLOSET�TOILET� NC—A/MNOLQ UNITS—M.P <br /> BATHTUB REFRIGERATION UNITS—H P.EA. <br /> UVATOflY(W�SM BASIN� BOIlERS—B.T.0/H.P. <br /> SHOWEH aA5 FIRED A.C.UNITS—B.TL. <br /> NITCHEN SINK d OISP COnf,E�Alfl Rv.^,TFMF—O T 11 M fA <br /> OI!IIIW�!I/IEII WnLL HEATCn9 -�11 T U. M _. <br /> UUNORY TRAY _ . <br /> UNITNEATERS—[I.T.0 M <br /> CIOtMF.S WASMER EVAPORATIVE COOLERS <br /> URINAL CLOTNES OflVERS <br /> DPINKING FOUNTAIN VENTIUTION FAN <br /> FLOU�OflAIN HANGE HOOD <br /> A�CNFIOW PREVENTERS WIITER MEATER <br /> ROOf DRAINS—RAINLEADERS WOOD STOVE <br /> SINK�SERVICE—B�N.ETC.� MEfAL FIREPUCE!CMIMNEY <br /> FIREPUCE INSERT � <br /> HEATPUMP <br /> OAS PIPINO <br /> . EXHAUSTFAN - <br /> SV!TOTAL f 6U0 TOiAL <br /> P[PMIT � <br /> P[RMIT <br /> TOTAIff[ f TOTALfFF <br /> INUNf4El0�f.v IIFeN9Ef&1Ctl gI0E9E10�Ce • R�NCHECKNUMBER FEE pECEiPTNO. <br /> U5!(UNl LOf AAE11 /" <br /> V�C�NT B�IE FEES VALUATION FEE <br /> OYES OIIO <br /> fYPE OF C(1NSI OCCUi�NCY GIIOUP NO Of OWFLLINQ UNITS BUILOING S <br /> PIUMBIN6 <br /> 6Uf W Bllf(1 NO Oi$fONIE$ MeM OCC LOAD <br /> MECMANICAL <br /> OTNER <br /> FIRE SPRINKIERS REOUIRED O YES D N STATE BUILOINO 9URCNAROE <br /> STATE ENEfIGY SIIRCHARGE <br /> APVIiCh110M�CCBr PLANSGNECMEOfiY �PPq.FORI95UANGEBY <br /> PUBLIC WORK9 <br /> TOTAL <br /> PROPERTV OWNERS ARE RESPON518LE FOR DETERMININO ALL <br /> PROPEHTV LINE LOCATION9AN0{iELATED EASEMENTS. • <br />