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lir�'PLICA�ION FO�a--' <br />'".E".`°."" C p N ST R U CT 1 O N <br />cm ov <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259-8810 TO BE COIv1PLETED IN INfC • PLEASE PRlNT <br />❑ DEMOLITION ❑ COMBINATION �'I BUILDING ❑ MECHANICAL <br />OWNER M�R�DDRE55 � C�iV 2iF <br />TAc.�' ,Bu,�:�css sd�5' ,7,7 /��z GJ C�+-✓'c-7 S��vy <br />...,...._.,..,,�..«�.:u�o rananooness cnv ziP <br />PLUMBING CONiRACtOR <br />MAIL <br />MPIL <br />M�il <br />�Z <br />everetl <br />� <br />❑ PLUMBING ❑ SIGN <br />PNONE <br />�S'9 -9d 7� <br />PHONE <br />�i�ONE �iCEnSE • <br />'95� s�a6 G/NA�EC /SZ�k�' <br />PI�OHE L�GENSE • <br />PHpNE UCENSE• <br />iOf WOAN <br />NEW ❑ ADDITION ❑ ALTE7ATION ❑ FEPAIR ❑ DEMC�LITION ❑ WOOOSTOVE;FRPL.INSERT ❑ BUILDING RELOCATION_ <br />pN OF WORK ICOSi OI MP�ERI 5 PW 5 LABOPI <br />!�i <br />;,-" _y_.r--. � rS�Y� i ,�n <br />...�L',�i l �AA2%IrJ��vl <br />useoveuaoinc T-- <br />/�e5i10eN%IACr <br />LEGRL DESLRIPTION O� P/ROPERTV �StlOW N flE�IC <br />LOI�/—BLOCKJ�--O� � �r d. <br />0 <br />•OfJFESS <br />PLUMBING <br />NO. TYPE OF FIl(Tl <br />WpTER CLOSET (TOILET) <br />BATMTUB <br />UVATORY (1YASH BASIN� <br />SMOwER <br />KITCMEN $INK 8 DISP. <br />OISHWASHER <br />LAUNORYTRAY <br />CIOTHES WASHER <br />UFINAL <br />OHINKINGFOUNTAIN <br />� PLOOR DRAIN <br />;FLOW PFEVENTERS <br />° ORAINS — RAINLGAOE <br />�SERVICE — 6AP. ETC � <br />SUBTOTAI <br />PERMIT <br />TOTALFEE <br />cories <br />a <br />I HEREBY CERTIF�I THAT I HAVE READ AND EXAMINED THIS AP� <br />PLICATION AND KIJOW THE SAME TO BE TRUE ANO CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHERSPECIFIED HERE- <br />IN OR NOT. THE GHANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANYOTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. . <br />SIGNAiURE OF GONtRACTOP OR AUTHOR12E0 AGENi ❑ATE <br />X\ I,, �/,. �r �,�..� , !- 8 g8 <br />MECHANICAL <br />T'PE OF EOUIPMENT <br />A/C — A/MNOIG UNITS — H P. <br />FEFRIGERATION UNITS — HP. EA. <br />BOILERS — B.T.0 MP <br />GAS FIRED A.C. UNIT$ — B T.U. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WALLMEATEf75—B.T.U. M <br />UNIT HEATEflS — B.TL. M <br />EVAPORATIVE COOLERS <br />CLOiMESORYERS <br />VFNTILATION FAN <br />pANGEH000 <br />1YATER HEATER <br />WOOOSTOVE <br />METAL FIREPLACE 6 CMIMNEV <br />FIFEPII�CE INSERT <br />HEATPUMP <br />GAS PIPING <br />E%HAUSiFAN <br />= SUB TOTAL <br />f PCHMIT <br />l <br />���/" ' l I I TOTAL FEE s� �� <br />�� PT O <br />� PLAN C (.K NUMBER FEE RECEI N. <br />iRON:5Et0eCfl AE>R SEIBACN SIOESE1BnCK ` ` ` ,�/� � ��. 1� <br />, ��%��� �vv 5,�a � <br />usc coNe �ot nnen vncar�r sne FEES VALUATION FEE <br />� YES []NO � � �_(� � <br />� BUILDING 5 ( (�/ � <br />rvP[O� NSi OCCUPPNCYGROUP NOOPDWFLLIN6UN115 <br />, � � N �- � B PIUMBING �i <br />SitE O� OIDc No Or ,iORiES MAx OCc Lt <0 MEC4ANICAI � <br />�. / <br />OD.S,� Z �P <br />o �. OTHER � � <br />. <br />FIRE SPRINKLERS REOUIRED ❑ VES �NO - STATE 9UILDING SURCHARGE <br />i <br />STATEENERGYSURCHARGE <br />GL`pLl(<�IOf:PL B� PLANSI:HECNEDBY APPRfOP�SSU�NGEBT � <br />PU�LIC WORKS <br />/� �j "fOTAL <br />� PROPERTV OWNERS ARE RESPONSIBLE FOR DETE?MINING ALL <br />PROPERTY LINE LO�ATIONS AND RElNTEO EASEM'cNTS. <br />� <br />