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APt LICA.TION FOR , ^ everett <br /> '"E""°'"° CONSTRUCTION O ' <br /> pin oF <br /> everett PE RMIT � <br /> BUILDING DEPARTMENT I <br /> 259-8810 Tp BE COMPLETED IN INK- PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING Sd MECHANICAL ❑ PLUMBING ❑ SIGN �I <br /> .. owr�ii+ /fn7.4TNfF � euu.�oma^.�;s /c'n,r :qir �r�ov[ �. <br /> �II,I'�J �. �OCk � /TSSJC. �DD I' S.0• G.L�C'FC/T I'Jlq(1_ "�9 FC:f�t// /U.CUy J J.>'/��y . <br /> ��� u+un�tciu�u��um�e�a T rn•n•onNcss +r n� vnove <br /> et�ena�co�+inncion / ei.�i .+nnacss cm :ir ��r�oNt. uc�Hsc. <br /> Q � E�–��C/ l U/LO�JZ��./rJC.'G <br /> ��w rAICnAyiCqICON�PPCifI �Ull>f)DPE55 GfV Z6 Pl101f IICENS[ • <br /> s l�n� n'�r�i�EkATion�S,.a-, i��� u,.��yro,�Jw,�� zov G=om�wus g�ozb �7s-6�7� <br /> ~ GWNf11NtiCONiRiQOR hIRI1.AD�0E+S CItY ]f O lICl.Nti�• <br /> n <br /> ��� CLASS Oi W(1Rh I <br /> ❑ NEW � ��DITION ❑ ALTERATION ❑ REPAIR ❑ �EMOLI110N ❑ WOODSTOVf:;F(iPL.iNSERT ❑ BUILDINIi RELOCATION <br /> ��i WLU�➢Of10�1JWn(i1..GO5iOf1.lA1C��AL51'WSLfI�D(i, <br /> rJ � J D�� P_ <br /> ��� uisc��Newor:. cei,onl S si.–�+�. <br /> • <br /> 1NSi�N7iO.0 Cr (o c9. GAS Y�kid �d�•q��TioNEv iv.✓d J�m.tr Oci .Y <br /> � usr.opr ow�'o1nm I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS AP- <br /> �N �' IrGO �Fl�LOR PUCATIONANDKNOW?HE�,:METOBETRUEANDCOFRECT.�LL <br /> t'�� �u,ai�escnir�rior+o�Paonearv�seowHonowouniracNrou�coaies PROVISIONSOFLAW3ANDORDINANCESGOVERNINGTHISTYPE <br /> OF WORK WILL BE:.OMPLETED WITH WHETHER SPECIFIED HERE- <br /> ��„� ioi—aioc�—or IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUMc TO <br /> �� GIVE AUTHORITY TO VIOLATE Oii CANCEL THE PROVISIONS OF <br /> � ANV OTNER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> y 51GNl+iuREo��CONiaAciC,RORauLbn430aGCNr n�d[ <br /> V� y <br /> ' y. �� A <br /> vao�Ecr,.-naess +i=�uuN rs cn.aos�.�tss i mu+s�no <br /> �-EG CNP/TNN Gv . cuc.tciT <br /> PLUMBING MECHANICAL <br /> ryp, TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WPTER CLOSET�TOILET) A�C–AiHNOLG UNITS–H P , <br /> . . BATMTUB REfRIGEPATION UNI75–N P.EA. . <br /> � � LAVATOflYIWASHBASIN) BOIlEPS-6i.WMP I <br /> I c�, SMOWER GASFIPEOAC.UNITS–BT.0 �OOE�. ' <br /> �� NITCHENSINKd015P FORCED��RSYSTEMS–BTV FA <br /> 1 � DISMYASHER WALLHEATEf75–BSU M <br /> _ LAUNORY TPAY UNI'f HEATERS–8.T U M <br /> �� EVAPORATIVE COOLERS <br /> CLOTHES WASMER <br /> I —' URINAL CIOTHES DRVERS <br /> DFINKING FOUNTAIN VENTILATION FAN <br /> � FIOOR DRA�N RANGE HOOD <br /> IOPCKPLOW P�EVENTERS W�TERHEATER <br /> _� ROOF DFAINS–PAINLEOOEAS LVOOD STOVE <br /> SINK ISERVICE–BAR.EiC 1 b,ETA�fIPEPI.ACE d CHIMNEY <br /> FIPEPIACE INSERT <br /> '�_ ' MEAT PUM11P <br /> , �_I GASPIPING <br /> E%MAUSTFnN <br /> � SUBTOTAL S SUBTOTAL <br /> O�� PERMIT S PERMIT <br /> � TOTALFEE S TOTALFEE <br /> �upVi 5Et0>c� � AE�q SEiO�cn SioE SEiBeCK ✓��H�MECI(NUM9ER FEE PECEIPT NO <br /> ��1�1 usc toNe LOT ARI F vnca+r srtc FE�S VALUATION FEE <br /> :�v[5 Yr�o 5 <br /> •.��: nrcovs* occuneHcrcaour �io orowruivcmms <br /> BUI�OING <br /> PLUMBING <br /> ..:(O�fi�oG NO Of 5*OMES i�>x oCC �O�D MECHAi:�GAL <br /> OiHER <br /> PIRE SPRINKLERS REOUIRED ❑YES ❑ NO STATE BUILDING SURCHARGE <br /> STATEENEHGYSURCMARGG <br /> _�,, ,, ,,,,.,,,; ��v v�eNSCr�ECKE�Br arrnri�ai�sucr�ecn+ pUBLICWORKS <br /> TOTAL <br /> �. � <br /> PROPERTYOWNERS ARE RESPONSIBLE FOR DETERMINING ALL <br /> PROPERN LINE LOCATIONS AN�PEIATED EA$EMENTS. <br />