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. . '. . . . . . . . . . � '�... `� ♦ . . .. ..... . . ...�.L�..A.. . ..r u�. v... ...�..r�r'�a:L9'1; <br /> !� <br /> iw�PPLICATION FOI:� � ���,�„ ,�. <br /> '"'E"`°"� CO N STR U CT I O N e : <br /> CITY OF <br /> everett PERMIT - � <br /> BUILDING DEPARTMENT E <br /> 259•8810 TO BE COMPLETED IN INK• PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION �BUILDING ❑ MECHANICAL ❑ PLUMBING ❑SICiN i' <br /> i <br /> OWNER MMLAU�RESS CITY ZIP PMONE � <br /> �►E-�� r�i�iSFa� 4�,� lu «r=�aue,u�-� r�n r=��r�-r— �i�. ?E�'l-3�S ` <br /> �RCHIflLTOPDFStiNF.R M�R�DORE55 CIIY 21P PMONE � <br /> - �,_vn C ud-�r'R��� �ss'�4�hS � <br /> GE ER�L LONi � TOR MML ApOf1E55 Lltt 21P FNONE 4CENSE• <br /> � f+?(3AL22hFSE� <br /> MECM�NIL�LLONTR�LTOq M9LAOORE55 C�TY 21P PMONE UCENSE : <br /> 1. <br /> PWIABiNGCONTR4GTOfl IA�ILe00HE55 CITY 2iP P11DNE UCENSE• i" <br /> ! <br /> P <br /> CLASS OF WOHR F� <br /> �(I NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUII.DING RELOCATION �;� <br /> WIU�ON OF WORN�COST OF M�IERULS PWS L�BORI p <br /> M � <br /> UESCRIBE WOFN �� f� <br /> TFAn[?cFrrGY� 2EE�PEIZ 12 #( SI• - r � <br /> USEOF BUIL0ING 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• �� <br /> PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL ' <br /> LEO�LOEFCPIPTIONOFPFOPEPTVISMOWNBELOWOP�1TaCHiOURCOPiE51 PROVISIONSOFIAWSANDORDINANCESGOVERNINGTHISTYPE <br /> �i� OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• � <br /> �or��e�ocK—oc G Q"' t N IN OR NOT.THE GRANTING OF A PERMITDOES NOT PRESUME TO E <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL lAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. . <br /> SIGNATURE OF CONTRACTOP OR Al1THORIZEO ACENT 04TE l <br /> X _ � ` <br /> � � � <br /> PPOJEGT�DDRESS �PPLIf.ANiS LITY BUSINE55lILENSE NO <br /> .T7IILS/ ��� <br /> PLUMe1NO ' MECIiANICAL <br /> NO. TIVE OF Fl1(TURE QH ITEM FEE NO. T'PE OF EOUIPMENT FEE - <br /> W�TER CLOSET ITOILETI AiC—NHNDIG UNI7S—H.P. <br /> BATHTUB REFRIGERATION UNITS—H P.EA. �, <br /> UVATORY 1 WASM BASIN� BOILERS—B.T.U./H P. z <br /> SMON/ER GAS FIREO A.C.UNITS—B.T.U. i� <br /> KITCNEN SINK S DISP. FORCED AIR SYSTEMS—B T.U. M EA. <br /> 1' <br /> OISHWASMER WALLHEATERS—B.T.U. M <br /> UUNDRYTRAY �NITHEATERS—B.T.U. M <br /> CLOTHES W�SHER EVAPORATIVE COOLEFS <br /> URINAL CLOTMESOFYERS <br /> DRINKING FOUNTAIN VENTILATION FAN <br /> FLOOR DRAIN � HANGE HOOD <br /> BACKPLOW PREVENTERS WATER MEATEp <br /> ROOF ORAINS—RAINLEADERS WOOD STOVE <br /> SINK�SERVILE—BAR.ETQ) MhTAL FIPEPUCE Q CHIMNEV <br /> FIREPUCE INSERT <br /> i <br /> HEAT PUMP <br /> 6AS PIPING <br /> E%MAUSTFAN � � <br /> SUB TOTAL S 8Ue TOTAL �- <br /> PERMIT f P[RMIi �� <br /> TOTALFEE f TOTALFEE <br /> ' PLANCHECHNtIMBER FEE RECEIPTNO. ; <br /> fRONTSEiBACN RE�RSETB�GN SIpE5ET8ACK �� <br /> i <br /> use zoNe �OT�REA y�C�Nf SITE FEES VALUATON FEE [� <br /> ares or+o - 5 � <br /> BUILDING <br /> TY�EOFCONST OCCUP�NGYGPOUP NOOFOWELLINGUNITS � <br /> PLUMBING <br /> 512E OF Bl�b ND Of STORIE$ MA%OCC.LOAD MECHANICAL ' <br /> 1 OTHER �k' <br /> FIRE SPRINHLERS REOUIRED ❑VES ❑ NO STATE BUILDING SURCHARGE k <br /> STATEENERGYSURCHARGE t <br /> •VPIICAl10N�CG BY PL�NSGIECREDBY �PPR FOHISSUANCEBY pUBLICWOflK$ '� <br /> TOTAL � <br /> PROPERN OWNERS ARE RESPONSIBLE FOR OETERMININ�ALL <br /> PROPERTY LINE LOCATIONSAND RELATED EASEMENTS. <br /> _�i.�'d <br />