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�� `;'���PPLICATION f0`i;' ���,�„ <br />` ,".`w,°'"" CONS�TRUCTION O <br />, Cltt OF I <br />. everett PERMIT <br />, BUILDING DEPARTMENT TO BE COMPLETED IN INK• PLEASE PRINT <br />, 259•BBIO <br />� ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />' oweea �� Mniieooncss cirv am n�or+� � <br /> �r��,�Lq�`'1lf�ia�lA.r✓A��in - �,raH���;coJ f,��,cE7Tv8�o� 2Sz-3f� 8 <br /> �p[NIiEGi f1UlSiGNER M /O��E55 GiV ll� PNONC <br /> S�/YI ��ry LP ���ONE L�CENSE• <br /> GENER�lGO����aG10� MRiln0UhE55 <br /> S" M� Mea.00ness GIIV 21P P11ONE IICENSC• <br /> MEG��MrUL cON�MC.tOq <br /> FLUMBIN�ICONfR4C10R M�IL��OfiESS CIiV TIP 1`IIONE UCENSE • <br /> �� <br /> cuss ov wonr. <br /> ❑ NEW, ❑ �DDIiION I� AUEf7ATION I�„ FC-PAIR ❑ DEMOLI110N ❑ WOODSIOVE/FRPL.INSGRT ❑ �UIL�ING �ELOCMIbN <br /> ww+noN or wonn�cosr o�M��E nu�s rws unom <br /> 1� �O� - .� _ <br /> ocscn�ac uK <br /> ' s�i^, 2ooF �-IQ,L/��oti' <br /> useorew�on+c I HERC•BY CERTIFY THAT I FiAVE READ AND ExAMIPIED THIS AP• <br /> PLICAiION AND KNOW THE SAME TO BE TRUEANDCJRRECT.ALL <br /> LEOAl0E56A�Pt10NO��qOPERiY15NOWN0[LOW0��11ACHFOURCO�If51 pROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> � OF WORK WILL BE COMPLETED WITH WHETHER SPECIfIED HEFE• <br /> �oi/1:LGI�oc�or'�'�G IN OR NQT.THE GRANTING OF A PEHMIT DOES NOT PRESUME TO <br /> G�VE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ; <br /> ANY OTHER STATE OR LOCAL LAW FEGULATING CONSTRUCTION <br /> i OF THE PERFORMANCE OF CONSTRUCT�ON. . � <br /> SIGN�T �EOfCONTRACIOROAAUIHOB12E0AGENT DAIE <br /> I X , - �� <br /> �� — APPLIGNi'iC1IV USIN[SSLICCHSFN(1 � <br /> PROJECI�OD1t[55 <br /> PLUMBIN6 MECHANICAL �/� ( <br /> Hp, I TYPE OF FIXTURE OR ITEM—� FEE NO. TVPE OF E�UIVMENT FEE <br /> • WATER CLOSET�TOILET� A/C—11/NNO�G UNITS—H P. <br /> � BATHTUO REFRIGERATION UNITS—N P.EA. I <br /> U�ATONY�WASM BASIN� BOIlERS—�B.i.0/H P. <br /> GAS FIRED A�Q UNITS—6.T.U. <br /> SNOWEP <br /> KITCHEN SINN S OISP. FORGED AIF SYSTEMS—8 i.U. M EA. <br /> WALLNEATERS—B.T.U. M <br /> i� OISMW�SHER — <br /> UNITHEATERS—B.T.U. M <br /> � LAUNDNY THI1Y <br /> CIOTHES WASHER EVAPORATiVE COOLERS <br /> CLOTHESORYERS <br /> UPINAI <br /> DRINNING FOUNTAIN VENTILATION FAN � <br /> FLOOR�RA�N RANGE HOOD <br /> BACKFLOW PRE\'ENTERS WIITEB HEATEP <br /> ROOFDRRINS—RAINLEA�EHS WOODSTOVE �� <br /> �INK�SERVICE—BAR.ETC 1 METAL FIREPUCE 6 CH�MNEY <br /> FIREPLACEINSERT <br /> MEATPUMP <br /> GASPIPING � <br /> E%MAUSTFAN <br /> I <br /> I <br /> SUBTOTAL f SUBTOTAL <br /> PERMIT f VCRMIT <br /> � I TOTALFEE f TOT�LFEE <br /> ' p�AN CMECN NUMBEP I FEE NECEIPT NO. <br /> � ff10Nf5E1p�CK AE�fiSEIBACK SIpES[lOAGN <br /> � I <br /> usecor+e I LOtARE� VAC�NTSIfE FEES VALUATION FEE <br /> ' pvES CNO p���DING 5 <br /> TYP[OfLO�15i OLCIIPANLYGPOUP ��OOFOWELUNGUNITS <br /> � VLUMBING <br /> S�tf oF Bi0❑ NO or SioPiES M�%OCC IOAD MECHANICAL <br /> 1 <br /> I <br /> OTHER <br /> FIRE SPRIINKLERS fiEOUIRED ❑�ES ❑NO STATE�UILDING SUPCHARGE <br /> I STATEENERGYSUFiCHARGE <br /> APPIiGq110N�LG0� �LANSCBECNEOBY ��PRfOR155UANCEO� pUBLICWOFKS <br /> � <br /> I <br /> I TOTAL <br /> PROPER YLOINELOCATONSANDRELAfEDE SEMENT'SINGALL <br />