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, A�LICATION FOR <br />NSTR.UCTION <br />everett PE RM IT <br />DI-PI Of COh1AlUNIIY UI.Vf�LOPAIPN� SLIiNIUS <br />UTY HqLI 259-0ia5 <br />�vEkE77.�vn��nlot �COMDINATION ❑ 6UILDING ❑MECHANICAL ❑PLUM6ING PERMIT NO. <br />1111'�A'IN ' AtAll el]I)Nl�l ^� f II� ��- /11' I'Illni <br />1��a� t1� .� i-��Q��i a� I'�V Q Cyo .' Ja �1�2��3 ��: �5� <br />C \ �-, �e { 0 �� <br />AXCI1111(IONi`f51L11N V>II�DUHIU tlh lIP <br />GI�IHAILO�IN�C10N �tAR�lll)HU� tiil JIP <br />,VfUTANICAI CONINM IOH V,AII AOUk155 � 111 /IP <br />PIUVIUVGIUViNAIIUH 11111Mi)V.fSS llil /If <br />❑rie�a ❑noonion Onireannou ❑krrnie ❑oen�oiinoN <br />,,�������,. �,< <,.,x� <br />s ��`�\ 83 <br />ouckuu �roun c � y <br />1�C��•ac.� �ty��cy /y�r�,l, c�n �e�a`Y C�S � <br />reorosiou�i ornunui.r. I Hf_R[[31' CERTIFY THA� I FIAVC RCAD AND EX�MWED Th115 AP- <br />PLICATION AND KNOW TI-IE S�h1E TO 13E TRU[ ��D COIiK[CT ALL <br />ruosi <br />I'tltl`.f <br />Pl�il]I <br />�ICIM1N v <br />I lt 1 �5! e <br />r ❑sicr+ ❑enkncr ❑i�uuomcaeiocnnoN <br />1LG41 IItSCNIP110N OI 1'HOPtNh I?IION'N IIfLOAYON AitAC111OUN fOPIlSI <br />ioi _._niocr:_oi <br />��1\� ' o�� � ���� Y� J.� <br />'�S�GC� j�— O\ f�,. \ooSs� 1�� <br />lon nUt�uKs <br />��\O`� �n..�Ci.�•c�. �\1� _ <br />PLUMBING <br />NO. TYPC OF FI%7URE <br />W'A7fN CLOSET (IOLII'T) <br />xnr�iTui+ <br />I.AVAiOftY �N'ASH f1A51N� <br />v io�e r u <br />KITCHLN SINK A UISP <br />UIS\\'ASIILR <br />LAUNDHY THA1 <br />CIO7HL5 H'ASHLH <br />\YA7CN NIAifR <br />UHINAI. <br />ORINKWG �OUNTAIh <br />�LOOH DRAIh <br />VACl1U.N IINLAKI:HS <br />ROOI DHAINS—RAINLlAflfRti <br />SINK (SfB\9('.f —ItAX. [ iC I <br />$IUF YANU S�IIi <br />USf ZOtiI <br />T1'PI Of CONS� <br />54.I. Of PLDG <br />I INI ZONI <br />FEE <br />SU� TOTAL <br />e�umrz s <br />TOTAL Ff[ S <br />Siftf Fl SE i11ACK NIAK YTkD SIiItACI <br />�or ne[n ��,�cnvt sirt <br />i:Y65 f-.�O <br />OCCUPAN(YGHOUP �OOfOIVILLIAGL <br />NO O( SIUk11.5 hln:( Ot:C IOiAIl <br />HA9A1fNi IIIIIR�It�,An VIHI SI'HINKtIht <br />Nf QUIHI U <br />' 1'IS -'.AO <br />eonunveie OV UAiL <br />i fNVIRONNtti'7nl (HICK IJtii <br />1. f1UILUINC PLANS <br />3 flHf 111'[)HANI <br />J flNl PHOiLC110N515It.\t <br />5 GBAUI�G I%� �A'Al IU'.!t (l.l �1NI�'�7 GkIIIfI11,u(l <br />G URAIn�GI <br />7 INV'IHONA1fMnl I�ttPn( I S7n11n1INi <br />N HfAl1H01\fHICi <br />1 <br />API'I II,V If)'. TCC BI � PI AAS ( 111 (?:1 U IIl � AI'I'H I(1H I}yU4h'.I II'. <br />PROVISIONS OF LAWS i1ND ORDINl�NCIiS GOVFRNING Th115 TYP6 <br />OI- WORK WILL IlL CO��IPIJED bVlThl WIi[THC:R SPECIFIE:D HEREIN <br />OR NOT. TH[ GRANTING OF �1 P&Rh11T DOCS NOT PRFSUMf: TO <br />GIVE AU�HORITI' TO VIOLATC: OR CANCFL TH[ PROVISIOYS OP <br />ANY OTIiER ST�T[ OR LOG1L IAN' N[GULATING CONSTRUCTION <br />nR THI! PI'RFORMANCE OF CONSTRUCTION. <br />SIGNn,IUHIOFCGViRACTOHOR��UiNONIZIDAG[N7 [)AiL <br />X �-�\ ��Z��.n �� I I 1� I'l �1 <br />MECHANICAL <br />NO. TYPF. OF EQUIPMENT FEE <br />,\INCf>u0 l,Tliti—HP fA <br />gfIRIG1A�IIONUNITS—Hp IA <br />BCiiLI NS-11 P. L� <br />fntillKLl]AC UNIlS—iO�NAGLfA <br />i nuri o nua svsi i.vs—it r u n� �n <br />U'�AIIH141fRS—It7U fd <br />l,M1li III,\I I R�—it I U �lt <br />I A'APORAI IVf ( OOLlRS <br />CIO1HIti pHl'I°5 <br />�q u I11.4i I( )ti 14\N <br />ftnNGl HUOU <br />AIN IIANI)I ING UNI7— f F At <br />S I�)A't <br />Vtl I�AI i IRf PIA<L S CIIIAINEI' <br />PI AN UII C1: NUn11R. <br />FEES <br />SUB TOTAL <br />PFBMIT <br />TOTAL FEE <br />I <br />IIL <br />VA WATION <br />� <br />S <br />s <br />HfCK FfL <br />ftLCCII'7 NO <br />ItUIIIImG � <br />VI U,V IIINf, <br />.VI.(ILWlC,11 <br />O1HIH <br />LItC <br />I'1 ti�l I1 SI C 101fn) <br />70TAL <br />PI N111i CAl IU.1710F <br />tt III'. I`FUPI R11 A TI �I�-� I' U II� I IIIti �I'4ll I 1 H6 Iti lt)Cit I'1 N�VII <br />ttt <br />