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j . ry � ' � j '. i'ii <br /> : A'�PLICATION FOR�:� ' ���,�„ "'', <br /> ; '".E".`°`"" CONSTRUCTION <br /> � CIfY O� <br /> � everett PERMIT . � <br /> � BUIIDINGDEPARTMENT TO BE COMPLETED IN INK- PLEASE PRINT ' <br /> �59•8B 10 <br /> ❑ DEMOLITION �COMBINATION �BUILDING ❑ MECHAkICAL ❑ PLUMBING ❑ SIGN . � <br /> owr�en u�il eooncss Cttt ar vIIONE I <br /> ?��0� f-�o7'_Y�s_=�_�.7?��/�� �I i 9�0� 3s3 ' `,rs 89 <br /> ARCHIflCI O110k5�ONEf1 M�n noon[s5 ci�' ar r�oH[ <br /> T—v�non /�,ma�2 /h,a�ivi f7.�-� � <br /> 6E EnM.LOHIR�GIO� MML e00�E5S C�IV i�P P��ONE ��GENSE• <br /> � h� <br /> MECIUNiGLGONIp�GiO� M�IUL`011[59 CPY 21P P��ONE UCENSE• <br /> PLUMBMOCONIMLIOn M�R�ON�E59 CIP� 2iP PiIONE IICENSE• <br /> c��es or wonK <br /> ❑ NEW ❑ ADOITION ❑ AIiERA110N ❑ I7Ef'AIR ❑ DEMOLITION ❑ WOODSiOVE/Fi1FL.INS[f7T ❑ �UILOING fiELOC�T�ON <br /> + vetu�noNorwonnicostoriaauueisr�us��oom U <br /> ; —�-�.� �c�-� ,0�}-1 ° <br /> � �ESCRiBE WORK <br /> C�+ NS'� �s- � <br /> uaaoo auuoiNa I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINEO THIS AP• <br /> . �.�� PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECi.ALI <br /> Lea�io[scnip�w��o�onarcarns�rowHne�owon��recnrouncoriES� PROVISIONSOFlAWSANDORDINANCESGOVERNINGTHISTVPE <br /> � ? OF WORK WILL BE COMPLETED WITFI WHETHER SPECIFIED HERE• <br /> �o��=Ga�oc�—oF_ IN OR NOT.THE GFANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTIIORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> �NYOTH[R STATE OR LOCAI lAW REGULATING CONSTRUCTION <br /> ; OR THE PERFOFMANCE OF CONSTRUCTION. � <br /> � SIGNAIUPEOFCONin O� t��� EDAGENf On1E �I�� /� <br /> I• A <br /> :'BOJEGI�OONE55 APPLI ANT9CIlYBU5WE55LICEN5EN0 <br /> r � <br /> i <br /> X iLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEH <br /> ( WIITERCLOSET�TOIIET� A/C—A/HNDLOUNITS—H.P. <br /> ,� BIITNTUB — REFRIGERATIONUNITS—H.P.EA. <br /> UVATORY�WASN BASIN� BOIlE�S—B.T.0�N P. <br /> � SHOwEP — dASFIREDA.C.UN1T5—B.T.U. <br /> � NITCHEN SINK 6 DISP. FORCED AIR SY5IEMS—B.T.U. M EA. <br /> OISMWIISNER � WALLHEATENS—O.T.U. M <br /> �� UUNORY TRI1Y UNIT HEATERS—�.T.U. M <br /> ` CLOTHES MMSHER EVAPOHATIYE COOLERS <br /> '! URINAI CLOTHESDRYERS — <br /> 7 ORINKINO FOUNTAIN VENTILATION FAN <br /> FLOOR OAAIN ' AAN�E HO00 <br /> BACKF�OW PREVENtERS WATER HEATER <br /> ROOF ORAINS—RAINLEADERS WOOD STOVE <br /> � SINK�SERViLE—DAR.ETC.) METALFIREPLAC�QCHIMNEV � <br /> ; FIAEPUICE INSEP7 <br /> � HEAT PUMP <br /> � OAS PIPINO <br /> �� EXFIAUST FAN <br /> � <br /> ♦ <br /> j SUBTO1Al 3 r" SUBTOTAL � <br /> 'i OERMIT f PCPMIT � <br /> � TOTIIL FEE f TOTAL FEE � �' <br /> �,i IRO�RSEIB�Ck RE��SEIOACN SIDESElO�CN PI.ANCHECNNUMBEI7 FE � AECEiPTNO.; . <br /> �� �� Z�' s' ���a �� �Qy fe <br /> ., <br /> USEIUNE �otene� . � er�rsrte . FEES VALUATION FEE <br /> ES ONO S <br /> �1 �J� BUILDING <br /> IYGEOiCONSi OCCUP1t7GYG110UP NO.OFDWCllINOUNIB <br /> � � � PIUMBING � <br /> j 52Eoroioa Noors�onie9 M�z.occ.to�o MECHANICAL <br /> � <br /> 7 �/�' ` ' OTHER <br /> i FIRH EPRINHlEf1S REOUIREDJ;(a.YES O�NO STATE 9UILDING SU�CHARGE <br /> 1 <br /> •� STATE ENEf1GY SURCH�RGE <br /> � . �ImUCeIIONeCGU� PL�N9GIECNEDBY earn.ronissu�r+eeev pUBLICWOPK9 <br /> �; r�� � ��� TOTAL c�J <br /> � PROPERTY OWNERS Af7E I7ESPONSIBL[FOR DET[Rh11NIN0 ALL <br /> PROPGRTY I.INE LOCATIONSAND RELATED EASEIdENTS. <br />