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�ne Eveiqreen
<br />�IIY OF
<br />everett
<br />BUILDING DEPARTt�1LIJT
<br />259-8810
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<br />TO F3G CO��IPLETED IN INI<- PLEASE PRINT
<br />p OEMOLITION i:] COMBINATION O OUILDING ❑ MECHANICAL ❑ PLUMBING
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<br />❑ SIGN
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<br />PLUMUING
<br />NO.
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<br />vun��rm..•nu.v�.nl��,wonnnnc��oimc�,� �
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<br />OF FIXTURE OR
<br />K'ATE� GLOSt Y fTORE i�
<br />B�TMTUB
<br />LAVATORYIWASN[1n5iN1_
<br />SHO�VER
<br />NITCHEN S�NK S 06P _
<br />LAUNpRYT�AY
<br />CLOTHES WnSMEP
<br />UA�NAL
<br />ORINKING fOUNTA��!
<br />FLOOP O�AIN
<br />DACKFLOW ViiEVENTEn;
<br />POOF ORMNS — �� ����� f�OC
<br />SINK ISEFlVICE — �n�. ETC I
<br />1 I�II'1� SI III�I.M
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<br />.�..:I. Or O� C.0
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<br />SUfiTOTAL '
<br />PERlAIT s
<br />TOTAL FEE S
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<br />�I
<br />FEE
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<br />'TES 'IND
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<br />I H[RC�Y CGRTIFY TI1A'� I FIAV� RFAD NND E:(Ah41NED 7111`.i Af'�
<br />PUCATIONANIIKNOWTH[S�MFTOE3ETf7UEANDCORRECi :•l.L
<br />PROVISIONLOF �AWS�NDORDINANCESGOV[RNING TIf15'�"�'E
<br />pp WpRI( WILL l�E COAIPLET[D WITH INHETIIEFl SPcCIFIED ���ERL�
<br />IPI OR NOT. TI1E G�7��JTING OI� A PERh11T DO[5 NO1 PRESU�'F TO
<br />GIV[ AUTFIORITY TO VIOLATG OR CAPlC[L TIi[ F'TiflV15�ONti pf'
<br />�WV OTFiGP STATE Ofi LOCAL LAbV REGUl�TI1JG GONSTFUC LiC�PI
<br />OR THF PERFORIdANCE OF CONSTRUCTION.
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<br />AI'1'I���.ni11'61:t11 Ilil'dNl "�] V�'I Nll 4i�
<br />MECHANICAL
<br />MC — �'��NCI.G UNITS — H P
<br />REF�IGEf11TI0'� UNITS — N P EA
<br />60�LEPS—DTU�HP
<br />G�5 FIIIED A C. UNIT$ — 0 T.U.
<br />FORCE���nSYSTEIAS—BTU M��
<br />--�— rA _'
<br />\vAIL I��f_nTERS — � T U.
<br />tiHITH[niFRS—OTU �'=
<br />EVnVO�b1TIVEf.GOI[(15 _
<br />CLOTHES Df1YEFl.i
<br />V CNT�LA �I
<br />f1nNGE HOOD
<br />WATER HE=�
<br />W OOD 5T0`/E
<br />WET�I F�A[Pll�CE 8 CFIII.INEY
<br />FIAEPLACL INSEfiT
<br />F�EAfPUMP _
<br />G�S PIPING
<br />ErlIAU7T F4N
<br />� SUOTOT�L
<br />PERIAIT
<br />TOTP.LFEE
<br />PLAN CHECM.NUM�ER IFEF
<br />OUILDING S
<br />PLUMO�NG
<br />IdECHANICAL
<br />OTIIEfi _
<br />STATE �WLDING SURCHAFlGE
<br />STA7EENERGYSUPCHnRGE
<br />FUdLIC �NORKS
<br />ITOTAL _
<br />FEE
<br />f�ECE��T NO
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