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� �cPPLICATION FOI.-� <br /> � '".E»'°'"" CONSTRUCTION ��!"„ <br /> : GITY OF <br /> � everett PERMIT <br /> i BUILDING DEPARTMENT <br /> ; 258•8870 TO BE COMPLETED IN INK- PLEASE PRINT <br /> 3 <br /> " O DEMOLITION O COMBINATION �8,'BUILDING ❑ MECHANICAL ❑ PLUMBING ❑SICaN <br /> � OWNEN M�IL�DORE55 /q WiY / �Z ' PHONE <br /> � `��� •.t ✓`0% Gyi: / • .'�' '�f � �'i /"�Z�'.3 J�J��-�50�� <br /> i <br /> �RCMIfECTOR0E51�NEP M�R���RE55 CIIY 21P PHONE <br /> �' <br /> GEyEp�L .OMR�CiOA MML ROURESu dn' iIP PHONE UCENSE• <br /> / <br /> : V ry 'Jz <br /> MECN�NIUL CONiH�GTOq M�R�OOHESS CrtY 214` PIIONE _IGENSE• <br /> FLUMB�NO CONiRAGtOR MML�pOBE55 C�IV ZU• PIIONE LICENSE• <br /> CLASS UF WOPN <br /> ❑ NEW ❑ ADOIT�ON ❑ ALTERATION REPAIR ❑ DEMOLITION ❑ WOJDSTOVE/FRPL,INSERT ❑ BUILDING RELOCATION <br /> v�w � og gO�sr or u•ieeui.s rws ue � _� <br /> 1 S�' > <br /> `� DE6C iBEwOF�t � , ^ 7 ,{ . . ; . QC`., <br /> I ,� .� �,�_ �' � � , �G�� �=� ��� ,• . .. i(aF��t-K• •�J' <br /> � OF PUIl01N � ,. <br /> ' , f I HEREBV CERTIFY THAT I NAV READ AND E%AMINED THIS AP• <br /> � � � PLICATIONANDKNOWTHESAMETOBETRUEANDCOARECT.ALL <br /> �+ �e �o RIPI NOFPR atns�ow A�ITALHFOURCOPIE51 PqOVISION50FLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> "� - �' ' OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br /> .i w —e�oc�_or W� � ���—�— INORNOT.THEGRANTINGOFAPERMITDOESNOTPRESUMETO <br /> U � �I GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> �� CC 3� f • � 7 ��� " � S�' � S � � %'�kL� ANYOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTION <br /> � OR THE PERFORMANCE OF CONSTRUCTION. . <br /> . �� SIGNAIUREOFCONI�ACTORORAUTHGRI2E�GENI pAi <br /> r . .� ' <br /> ' "` .3 �, <br /> e e a aC X f�<.�a�z � �Er 2. <br /> PROJEGT�OORESS ^ , ' � APPUC�NiSG�1YBU5iNE� L�^.4 SEN <br /> ' �✓'� � z � . Gi£- . <br /> i PLUMSINC� MECHANICAL <br /> NO. TYPE OF FIXTUqE OR ITEM FEE NO. TYPE OF EOUII'MENT FEE <br /> � WATER GLOSET ITOILETI A/C—A/HNOLG UNITS—H P. <br /> BIITMTUB f1EFRIGEPATION UNITS—M.P.EA. <br /> � . LAVATORY�W�SM BASIN� BOIIEPS—B.TL./H P. <br /> SHOWER CAS FIRED A.C.UNITS—B.T.U. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS—B.T.U. M EA. <br /> DISMWASHER WALLMEATERS—B.T.U. M <br /> UUNDRVTRAV UNITNEATEPS—B.T.U. M <br /> � CLOTHESWASMER EVAPORATWECOOLERS <br /> UN�NAL CLOTMES DRYERS <br /> DRINKING FOl1NTAIN VENTILATION FAN <br /> FLOOH DAAIN NANGE HOOD <br /> I BACKFLOW PRE�ENTERS W�TER HEATER <br /> � ROOFORAINS—R�INLEADEFS wOODSTOVE <br /> j SINK(SERVICE—BI1P.ETC.� NETAL FIREPLACE 8 CHIMNEV <br /> FIREPIACE INSERT <br /> 1 <br /> ' MEAT PUMP <br /> GAS PIPING <br /> EXHIIUST FAN <br /> � ' <br /> t <br /> SU!TOTl1l f 9U8 TOTAL <br /> VERMIT f P[NMIT <br /> �� TOTAL FEE f TOTAI FEE <br /> fRONi SETB�C1t RE�R SEiB�GK SIGE SETB�CN �N I:MECK NUM6ER FEE AECEIPT NO. <br /> usezone �ot�ne� ��cu+rsire FEES VAIUATION FEE <br /> OYES ONO <br /> BUILDING 5 � <br /> � 1YPEOhCONST. OCCUPl�NCYGROUP NOOFOWELLINOUNITS <br /> PLUMBING <br /> SIZE OF BLDO NO OF STORIES M1%.OCQ LOAU ��� <br /> MECHANICAL <br /> OiHER <br /> FIRE SPRINKLERS REOUIRED O YES ❑ NO � STA7E BUILDING SURCHARGE (7 <br /> STA7EENEPGYSURCNARGE <br /> �VCLICR110N4CC 0• P��NSCNECNEDBV APPR fOR155WNCE8V <br /> PUBLIC WORKS <br /> TOTAL ��` <br /> PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING AlL <br /> PROPERTV LINE LOCATIONS AND RELATED EASEMENTS. <br />