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��-�NPLICATION FO'r��' ���,�„ <br /> '°.E".,°,"° CO N ST R U CTI O N O <br /> CIfY OF <br /> everett PERMIT <br /> BUILDING DEPARTMEtJT <br /> 259-8910 TO 8E COMPLETED IN INK- PLEASE PRINT <br /> ❑ DEMOLITION D4 COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> ovnn n r�na nnnnc�:^, - cnv ziv v�wr+i <br /> C�IUCK CASC ►�O. 'Box 56'L2 EVE:2�TT, w� q82o6 258-214 � <br /> �nanrir.�nr u�s�m�en Me��nnw�ess cav tir P�IDNI. <br /> (:t'�LiUL Vl�1�nnCtU�� MAit npllptSS C��Y tl� olipNE LICENSE• <br /> ow y��.2 <br /> r��.uurur.m�.ornrur.�qn Mnn nunncss atr zir m�a�c UCENSE. <br /> PWA�PiNr:[pNIR�UOp M�II.�D[lll[55 CIIY ZIP PIIDN[ UCGNti[ • <br /> �EES PlUmS1 niG EVtIZET'i <br /> a�ssni wonr <br /> ❑ NEW ❑ �DDItION ❑ AL7ERATION ❑ REPAIfi ❑ DEMOLITION ❑ YVOODSiOVE/FpPL.INSERT ❑ BUILDING RELOCaTION <br /> wi u+nnn or won..r.o,�rn I.I.V I IIiN.S PLUS UpOpl � <br /> 6�300.DO <br /> oeseam.rrnne <br /> FlDD CA��NE,75 PIU �»Q,�(, Gc2 T�u�ur �mP20v6'MFjJT IJO STQ.uCrl[RA�. <br /> u�r o� m:n.muc <br /> ����� �`0� I HER[BY CERTIFY THAT I NAVE READ AND EXAMINED THIS AR <br /> PLICATION AND KNOW TI1E SAME TO BE TRUE ANDCORRECT,All. <br /> icon�oiscniruor+oinnorcn�risnowHocwwonn�incu�ouncorrtsi PqOVISIONSOFLAWSANDORDINANCESGOVERNINGTHIST\'PE <br /> OF WORK WILL BECOMPL[TED WITH WHETHER SPECIFIED HERE• <br /> io�_�iocw_or IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIJE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIOMS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCtION. . <br /> SICNAIUREO�LONiq4CTORORAUiMOPIZEDAGENT 04TE <br /> 1'�4l 1+11'rCH�(.C.�S ��E�— \ac�. $-�fi-8�7 <br /> PROJECi.1DOPE55 A��UNNTS CIIV pU51NE 55 UCLNSE NO <br /> 4 bo I t�m S i <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIIITURE OR ITEM FEE NO. TYVE OF EOUIPMEN7 FEE <br /> WATEA LLOSET�TOI�ET� A/C—A/MNOLG UNITS—NP. <br /> B�TNiUB �EFRIGERATION UNITS—H V.EA. <br /> LAVATOflY�WASH BASIN� BOILEflS—B.T.0/H P. <br /> $MOWER GAS FIRED A C.UNIiS—B.T.U. <br /> NITCNEN SINK A OISP FORCED AIR SYSTEMS—87.U. M EA. <br /> DISHwnSMER W�LLIIEATERS—B.T.U. M <br /> LAUNORYTPRY UNI'fHEATERS—B.T.0 M <br /> CIOTNES WASNEII EVAPORATIVE COOLERS <br /> U�INAL CLOTHESDRY�RS <br /> ORINKING fOVNTAIN VENTIIATION FAN <br /> FLOOii ORnIN RANGE HOOD <br /> OnCNFLOW PREVENiERS WATERNEATER <br /> R�OF OfialNS—RAINLEnOERS ��000 STOVE <br /> SINK�SEPVICE—OAfi.ETC� METAL FIREPLACE Q CNIMNEY <br /> FIREPU�CE INSERT <br /> HEATCUMP <br /> G/15 PIPING <br /> EXHAUSTFAN <br /> SUBTOTAI f SUBTOTAL <br /> PERMIT f PfNM�T <br /> TOTALfEE S TOT�LFEE <br /> �uinirsiin�r.: � nunseio�cn Si�ESEIDeCR �ANCMECKNUMBEfl FEE RECEIPTNO. <br /> US[JUNt LO�A.. • <br /> vr,u�tsre FEES VALUATION FEE <br /> ❑YC$ OND <br /> BUIIDING 5 <br /> �v�'CO�CON51 nf:f.UPRNCYGitOUP NOOlpWFIIINGUNIIS <br /> PLUMBII�G <br /> YIC 01 f!IOU �ln �If FIU�45 MPY OCC LOAD <br /> MECHANICAL <br /> OTHER <br /> fIRE$PRINNLERS REOUIRED ❑ YES O NO <br /> STATE BUILDING SUPCIiARGE <br /> STATE ENERGV SURCHAfiGE <br /> ml�i4.:.uiRlICCU. �Y;q;C��ECnEUOY �I•PPIOf1i550eNCE0V <br /> PUBLIC WORNS <br /> TOTAL <br /> Pfi01'ERTI'OWIJERS�RE iiESPONSI�LE fOR DETERAIINING ALL <br /> PROPERTV LINE LOCATIONS AND REIATED EASEMENTS. <br /> . . . . . . . .-a . - . <br />