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c`: :�,,� � <br />,�..E�.,o,„� wFRLI� ATION FO�:' <br />��tt°° CONS�RUCTION <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK- PLEASE PRINT <br />evereN <br />e <br />❑ DEMOLITION ❑ COMBINATION �BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MFIL ROpR65 CI�Y ZIP PHONE <br />�otJ4L� C�AV�S ZZc�Z NoYT �v�RET� 9820� LS"�-U6L�0 �o KE <br />ANCIUI[CIOROFSIGNEF MhIL�DOf1E55 CRY )O' P11pHC <br />SAME <br />MECIUWUL <br />MAq �pURE55 <br />M�R �OORE55 <br />lil' <br />VWM9INGCONfRAG10�1 M41L�DORESS CrtY ZIP PUONE LICFNSE <br />C1�5$O� WOeM — <br />❑ NEW ❑ ADOITION �, ALTERATION �, REPAIR ❑ OCMOLI110N ❑ WOODSiOVE/PRPL.INSERT ❑ BUILOING IiELOCnTIOH <br />y Z��J <br />oestnme wonrc EPNI F �� N5 1 <br />INSULAI'E pUTStDE WALLS A'S AND CE <br />RFsi DErGS � <br />ioi +�2 ewcK� <br />,V.�y.Z^Z c z �-1�,�� <br />PIUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET �TOIIET� <br />LAVAT017Y �WASH BASIN) <br />SHOWEH <br />NIiCNEN $INN 8 OISP. <br />DISHWnSHER <br />LAUNORYTRAV <br />CIOTHESWASMER <br />UNINAL <br />ORINKING FOUNTAIN <br />FLOOR ORAIN <br />BACKFLOW PREVENTER$ <br />ROOF ORAINS — RAINLEADERS <br />SINK ISEFVICE — B�R ETC 1 <br />SUG TOTl1l <br />PERMIT <br />TOTAL FEE <br />�rsere•cn <br />ZONE <br />OF CONSt <br />or moa <br />FIRE SPRINKLEPS REOUIRED ❑ VES ❑ NO <br />OF <br />FEE <br />s�oe screncK <br />WCANi SIIL <br />❑xE5 pN0 <br />NO Of O WGLIING UNIIS <br />M�%OCf, iono <br />Br <br />F��2 gEDlCaoh��— IQENOVE P�.AS�EK+uiTH REPLACE w <br />I HEREBY CFRTIFY TI1AT I FIAVE READ AND EXAMINED THIS AP• <br />PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.�LL <br />PROVISIONS OF IAWSAND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COAIPLETED WITH WHETHEP SPECIFIED HERE- <br />IN Oq NOT. THE GRANTING OF A PERMIT DO[S NOT PRESUME TO <br />GIVE AUTNORITY �f0 VIOLATE OR CANC[L THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CCNSTf7UCTION <br />OR THE PERf �;7MANCE OF CONSTRUCTION. <br />SIGN4IUPE O� GONipAC1GR Ofl AUIIIORIZCO AGCNf p47[ <br />X �� �� gl�l� <br />LT,lNS[ NO <br />MECHANICAL <br />TYPE OF EOUIPMENi <br />A/C — AMdOLG UNITS — H P. <br />REFRI3ER�TION UNITS — M P. EA. <br />DOILERS — BS U /N P <br />GAS FIRED A C. UNITS — 8 7.U. <br />FORCED AIR SYSTEMS — B.T U. M EA, <br />W/1LLMEATEBS—BS.U. M <br />UNIiHEATERS—�TU. M <br />EVAPORATIVECOOLERS <br />CIOTHESOHVERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER MEATEF7 . <br />WOODSTOVE <br />METAL FIREPV�CE 8 CNPANEV <br />FIREVLACE INSE(iT <br />HEATPVMP <br />GAS PIPING <br />E%HAUSTFAN . <br />SUB TOTAI <br />PEN\IIT <br />TOTFLFEE <br />PLANCHECNNUMDER IFEE <br />BUILDING . S <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BUILDINf} SURCHAPGE <br />STATEENERGV$URCNARGE <br />PUBLIC WORKS <br />TOTAL <br />0 <br />RECEiPT NO. <br />FEE <br />i�i+OP[RTV OWNEPS nRE RESPQNSIBLE FOR DETERMINING ALL <br />PRJP[RTV LINE LOCATIONSAND FEIATED EASEMENTS. <br />