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..,,.; i <br /> ;:. .: <br /> a�PLICATION FOh�� ���,�„ <br /> '"'E"'°'"" CONSTRUCTION e <br /> cm oF <br /> everett PERMIT <br /> BUILDING DEPARTMENT <br /> 259-8810 TO FiE COMPLETED IN INK - PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION �BUILDING ❑ MECHANICAL ❑ PLUMBING ❑SIGN <br /> �„Eq MMIA�DNE55 ��T�' ZiP �'��ONE <br /> '{�W� 'fpcnni�S �nrn !A�►Yc / �t�u,r,r=�-F'-fl�r�4 �.J.-+ G�rds�. r�, �Na_ <br /> ♦RCHIiEGTOROlSi NEP M�LL�DDRk55 CiIV Iln �nUNE <br /> �F /�.a ►�.-+'�'t..Dv.� <br /> GENEfl�L CONLP�GIO� M�IL�UU�ESS LIIV 211 iO1DNE UGENS!� <br /> �afN� L�-"^�uR/�",nh-a,U�vco�.r:�n��n� �.��� �.7vr.���Lun�.(� �r��rn qS�2a ���o��v <br /> MECM�NIC�LGONTR�LTOq M�iLA0�RE55 Ci1Y 21P PIIONE UCENSE• <br /> n.�,.o .� ,�C�'flNC� 1144-�. 17Di9-A�� NE K�eK1/kNfl� o-lA 9?,�^�� �r15-G�l,f� P-bW�M4�7P� <br /> PLUMBINGCONiPAC70R MML���RE55 LIIY 2iP PIONE 4CENSE <br /> M� l GP�� A�irntR�r1/� 15�2�� UhD��P.N!-�I . Mi�Pf��G}u1tr.�✓ii2_. 3a7�?r;� Mx.Lc?x1�7Ds <br /> CL�35 OF WOAN <br /> � NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ �EMOLtTION ❑ WOODSTOVE,"RPL.INSERT ❑ BUILOING RELOCATION <br /> V�L�Uy�I��ONOFWDRKI�OSTOfM�IERIAl5PW5L�90R1 � ^ <br /> (J'- 7P� / �'7 C�1� /�1+f��rJ ��. <br /> DESCRIB WOPN 1 <br /> N <br /> useov euaoir�c I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINcD THIS AP• <br /> ��y'�p;(y1�L �• PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL <br /> lEO�LDESCPIPiIONOFPROPERTYISMOWNBELOWOR�ITACNFOUNCOPIE51 PROVISIONSOFLAWSANDORDINAi�CESGOVERNINGTHISTYPE <br /> � �P��_�� OFWORKWILLBECOMPLETEDWITHWHETHERSPECIFIEDHERE• <br /> �o�—e�ocK—or IN OR NOT.THE GRANTING OF A PERMIT�OES NOT PRESUME TO <br /> GIVE AUTHORITV TO VIOLATE OR CANCEL TIiC- PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATi�G CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCI'ION. . <br /> SIGNATU E OF CONTP�CTOR OA AUTNORIZEU AGENT UATE I <br /> N ` � <br /> PpOJECT�OORE55 APPII.�NiS CIfY BUS�NE SS IiCENSE N <br /> )[4. ' ;?,^O�� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WIITER CLOSET(TOILEn � A/C-AiHNOLG UNITS-H.V. <br /> 2 BATHTUB � � ) REFRIGER�TION UNITS-M P.EA. <br /> UVATORY IW�SH BASIN� BOILERS-B.T.U./H.P. <br /> SMOWER (3AS FIRED A.C.UNI-S-B.T.U. <br /> � NITCHEN SINN!OISP. FORCED AIR SYSTEMS-B.T.U. M EA. ) I <br /> DISHWASHER � WALLHEATEPS-B.T.U. M <br /> � UUNDRV TRAY UNIT MEATERS-B.T.U. M <br /> CLOTMESWASHER � EVAPORIITIVECOOLERS <br /> UHINAL CLOTHES DRVERS <br /> DRINKING FOUNTAtN VENTIUTION FAN <br /> FLOOF DRAIN RANGE MOOD <br /> &1CKFLOWPREVENTERS � WATERHEATER <br /> ROOF OflAINS-HAINLEADERS N�OOO STOVE <br /> SIKK�SERVICE-BAR.ETC.) METALFlREPLACE3CHIMNEV ` � <br /> FIREPLACE INSERT <br /> HEAT PUMP <br /> GAS PIPINQ <br /> E%HAUSTFAN <br /> SU!TOTAL 1 �� SUBTOTAL <br /> PEpMIT f P[RMIT <br /> TOTALFEE f f. � � TOTALFEE �- <br /> �RONT SETB�CIt RE�R SET911CK � &DE SETB�GK � �AN C ECN NUMB@H FEE ^C� pECEIPT NO� <br /> .,r ii Zo' 6''-Fo be-wk.. i �i � �, ��� l�� I (c, -�v3Co�` "-t�76o��' <br /> use zone LOT�pEA. y�c�NT SIiE FEES VALUATION FEE <br /> � (Z_ � yCes oxo s �� f - 1� <br /> TYPEOFCONSi OCCUP�NGYGROUP NO.OFDWELUNGUN115 BUILDING <br /> � v� I r�f ' PLUMBING <br /> S12E OF BIDG NO OF St�ONiES M�% OCG LO�O � �� <br /> � '{' 7lmT �I � MECMANICAL <br /> OTHER <br /> FIRE SPRINKLERS REOUIFED ❑YES NO STATE BUILDING SURCNARGE <br /> STATEENERGVSURCHARGE I� <br /> •VFLiGRiION�CG 9v PlANSCNEGNEDBY �PPR.FORISSt1ANGE3Y PUBLICWORKS <br /> � � 1•yc- TOTAL ()- i <br /> f <br /> PROPERTY OWNEriS ARE RESPONSIBLE FOR DETERMINING AlL <br /> ' PROPERN LINE LOCAT�ONSAND REIATED EASEMENTS. <br />