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,Mf,,,,„,� `;��wPPLICATION FOi': ` � <br /> CONSTRUCTION °°"`" <br /> an oF <br /> everett PERMIT e ; <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK- PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION t�BUILDING ❑ MECHANICAL O PLUMBING ❑ SIGN <br /> pWNER MAll�ppPE55 Cltt 21P PIIONE <br /> �PoB_r-�T P 5�; G��H,�,^, iZ33 N:Iv Nu�cz�r� Way S�qr��FWq 9�t77 Lo6 ,36G6Z32 � <br /> �RCNItEC10ROF510NER M�q�DDRE55 CIIY ZIP PNONC <br /> OENER�lCON1RAC10R IA�I��OpRE55 <br /> O�✓Nr'rlZ SQN,f' Ar A30U.1 Clry zir P��ONE LICENSE• <br /> MECN�Nip��OH1R�QOq Me1�s00RE55 Llrv 21P PIIpNE IICENSE• <br /> PWMBiNOCONIa�G10N MqL�DDUE55 C�TY 2iP PNONE L�CENSE• <br /> �qQTs PLUMBiNG I�z AvEa 5',voHoyiSl,l 4�29a S68'-423� Aan plbicN <br /> CU55 or wORn <br /> ❑ NEW ❑ AD��TION ❑ AITERATION ❑ REPAIR ❑ DEMOLIiION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCAiION <br /> V� �ONO�WOHK`COSIO�M�fENI�lSPWSLABOn� <br /> 00� �V <br /> .�'iK"'ww�21s s rA�2s w,Naow t Ef� <br /> � I T D.4T[/J � KiTcFlrN <br /> USE Of BWLOING <br /> IPrrS/p F.N Cr I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS AP- <br /> PLICATION AND KNOW THE SAME TO BE TRUE ANO CORqECT.ALL <br /> �eAio�1�IPTiONaO�����O�ERiVISNOWNBCIOWORAi1�LMf0URCOP1E51 PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> iorss e�ocr�orP[qr oF f_�ER�T7 DiuiSioN L OFWORKWILLBECOMPLETEDWITHWHETHERSPECIFIEDHERE <br /> , O IN OR NOT.THE GRANTING OF A PERMITDOES NOT PRESUME TO <br /> ACCO?O/NG T ��VT �IJF_;�.F OF ^�CO1POE/, ANYOTHERST1ATEORLOCA'EIOAWREGULATINGCONS R'�UCTION <br /> '` OR THE PERFORMANCE OF CONSTRUCTION. <br /> IN I�D(.UhN S OF P[ATES �Aq+C � SICNATUREOFCONLF4CTORORpUi110RIZ[DAGENT Dq1E <br /> IPi£Cpqoj OF SAIaF/NiSN �ouNTY df (•(�/�51.1i,v61 X�,� �� , Q� ��4/p� <br /> �(..�/m.e.•_ <br /> OpOJECi 1DDRE55 �PPtIL�NTS OiY BUSME59 LiLENSE NO <br /> I ? IS �U�� <br /> PLUMSIN6 MECXANICAL <br /> NO. TlPE OF FIIfTUpE OR ITEM FEE NO. TYpE OF EOUIPMENT FEE <br /> WIITER CLOSET�TOILET) q/C—A/NNOIG UNITS—H P <br /> BATHTUB qEFRIGERRTION UNITS— <br /> M.P.EA. <br /> UV�TORY�WASM B�SIN� BOILERS—B.T.II MP. <br /> SHOWER GAS FIRED A.C.UNITS—B.T.U. <br /> KITCHEN SINK 6 DISP. FORCED Alq SYSTEMS— <br /> B.T.U. M EA. <br /> DISHW�SMER WALLNEATERS—B.T.U. M <br /> UUNDNYTF�Y UNITHEATERS—B.T.U. M <br /> CLOTMES WnSHER EVAVORATIVE COOLERS <br /> URINAI CL07HESORYERS <br /> DNINKIN(i FOUNTAIN VENTIUTION FAN <br /> FIOON ORAIN RANGE HOOD <br /> BACkFLOW PREVENTERS WATER MEATER <br /> ROOF DRAINS—RAINLEADERS WO00 STOVE <br /> SINK�SEPVICE—BAH.EfC.� METAI FIFEPUCE 8 CMIMNEV <br /> FIREPLACEINSEPT <br /> HEATPUMP <br /> GAS PIPINO <br /> � E%MAUSTFAN <br /> SUlTOTAL ! SUBTOTAI <br /> PERMIT f IKRNIT <br /> I TOT�LFEE f TOTALFEE <br /> �AONTSEIO�CK RE�RSEIB�Cn S�oESETB�CK PIANCMECNNUMBER FEE REGEIPTNO. <br /> USE20NE LOTen[� y�p�NiSitE <br /> FEES VALUATION FEE <br /> ❑vE5 ONO <br /> TYPEOf�ON4t OCLUP�NCYGAOUP NO.OfDWELLINOUNlf3 BUIL�ING S <br /> PLUMBING �;IOO <br /> 512E Of 61D0 NO OI SLOHIE9 MAN.00C L0.1D <br /> MECHANICAL <br /> OTHER <br /> FIRE SPRINKLERS REOUIRED ❑VES NO STATE BUILOtNG SURCHARGE <br /> STA7EENERGYSURCMARGE <br /> �PPtiCafIONA�C Bv P�ANSI'nECKEDBY �PPq FORi95U�NCEBY <br /> �n,� PUBLIC WORKS <br /> OJV`� ' 707AL <br /> PROPERTYOWNERS AqE RESPONSIBLE FOR DETEfih11NING ALL <br /> PROPERN LINE LOCATIONS AND RELATED EASEMENTS. <br />