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�.PP�.ICATION FO1. ���,�„ <br /> '".E"ro'"" CONSTRUCTION O <br /> CIT O� <br /> everett PERMIT <br /> BUILDING DEPARTMENT <br /> 259•8810 TO BE COMPLETED IN INK • PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION O BUILDING �MECHANICAL O PLUMBINO ❑ SIGN <br /> •iwr�r.n �7VI�- o�CQIIJ /���tii ciiv� rir /i °N�7_ (l��CC � <br /> ��i2J�f2�E - �7 � <br /> u�U�rttCtOROk5�6NLR M�R�OD�E59 CItV S P O L <br /> 9HrtR1lf.O11�R�C�OP M�R��bRE94 Clry IIP VHO41 LILVISL • <br /> .��.n•.. C r� w 9 ���/ '�/'�nIC�7 �V � ��v � ^ � `V ` Y- <br /> �y � V' � Xl� +C�1iL�7 x.� 9S� S:. . � . <br /> OIUII&� 4C04�R�CIOA M�II ��DRE$$ CIIY ��_ IJ1'�y � /�lE - VCVIS( • <br /> \ /l <br /> y i� , �c_, <br /> r,��550�wJA� <br /> ❑ NEW ❑ AODITIO'� �Y AL1ERptION ❑ FEPAIP ❑ DEMOLt110N ❑ WOODS70VEiFRPL.INSE�7i ❑ BUILOt4G �7ElOC<IiC11_ <br /> .,�1("1 pr�ypw�co5�or i��qnie�.s rius V oon� <br /> AA/1 <br /> ✓%% <br /> �fSCniPtw n� ����� / �� . �O � � <br /> CD�tf'UF�7- � �� <br /> u�� o� nun w,c/n I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS Af`� <br /> �j /� PLICATIONANDKNOWTNESAMETOBETRUEANDCORRECT.AIt. <br /> LE64I1FSCF����O•iO��AO�EPiviSNOW��OELOW0�1�if�CNfOUAGOPlE51 PROVISIONSOFLAWSANDORDINANCESGOVERNING7HISTYP[ <br /> OF WORK WILL BE COMPLETED WITH WfiETHER SPECIFIED HERE� <br /> i��._eioc�—o� IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PR[SUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEI THE PROVISIOPlS OF <br /> ANY OTNER STATE OR LOCAL LAW FEGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> 90N�lU�E O�[ONtPRCTON OPAUIH0�4EDnGENI �AIE <br /> X (/'��� l- ��- �� <br /> �AelEc1•o0aE5/� / �� �rruC•NrOOU$�HEssuGE11,cN0 <br /> (/ / ' w <br /> IL/ � V'� <br /> PLUMBIN6 MECHANICAL <br /> NO. TYVE OF FIIITURE OR ITEhI FEE NO. T'PE OF EOUIPMENT FEE <br /> w�TEA CLOSET lTO�IEi� A/C-A/HN�LG UNI TS-M P <br /> BAiHTUB �EFRIGERATIONUNITS-MP EA <br /> UVATOHY�w�SH B�SIr�� BOIlE�S-BS U���P <br /> SHOWER GAS FIRED A C.UNITS-B T.U. <br /> NtiCMEN SINK 6 OISP F0�7CE0 AIR SYSTEMS-B T U M EA <br /> DISMWASNEA WALI��EATEf1S-BTL. M <br /> UUNO�Y ii7AY UNIT I�EATE�S-B'U M <br /> CIOtHES waSNEA EVAPOi1AiIVE COOLERS <br /> ��RINAL CIOTHES DRYERS <br /> OAINKtNG FOUNTAIN VENTIL�TION FAN <br /> FLOOA OAAIN RANGE NO00 <br /> BACKFLOW PREVE11TEn5 W�T[R NEAiEH <br /> ROOF OMP+S-P���+IE�DE�S WOOD STOVE <br /> SR�K�SERVICE-B.R ETC 1 METFL FIREPLACE A CNIMNEY <br /> FIRE�L/.CEINSERT <br /> MEATPUMF <br /> GAS f'IPING <br /> E%N�USTFAN <br /> SUETOTAL f lUOTOT�L � <br /> PEIIMIT f P[NMIT <br /> TOT�LFEE f TOT�LfEE <br /> �uUa�S[IO�f.r uf�u4�B�Ce SiDESCIB�CK <br /> aLAN�:MECR NUMBER FEE RECEiP1 NO <br /> •�s� iou� ior.nu �.c•rnsn[ FEES VALUIITION FEE <br /> orEs allo s <br /> r,a� orcrn�v w.cw••�icrcnour r+oorowrw��awms BWLOING <br /> PLUMBING <br /> •.,•tl 9i OIDa r1n��r StpNES M�v OCC InAD MECNANICFL <br /> OTNEH �i <br /> tIRE SPqINNlEFS�7EOUIPED O YES O NO STA7EBUILOINGSURCHARGE I <br /> STATEENERGYSUACHANGE <br /> _�� . r.�:.�.' 9. r�r.i'��.�qV1U�r �rcn �O�ii:WriCtBv PUDUCWORKS .— <br /> TOTAL <br /> — -- PROPERTYOWNERSARERESfO�i510LElOROC1Eia1•uultJGnll <br /> PROPEfiTV LINE LOCA710NSAND RELATED EASEfAFNTS <br />