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�,-�PPl.ICATION FO`►� ���,�„ <br /> '"'E".'°'"" CONSTRUCTION <br /> cm or <br /> ' everett PERMtT <br /> IBUILDING DEPARTMENT <br /> � 259-8810 TO BE COMPLETED IN INK- PLEASE PRINT <br /> � ❑ DEMOLITION ❑ COMBINATION ,� BUILDING ❑ MECHANICAL ❑ PLUM8ING ❑SION <br /> , �y <br /> � (7�Iilril�P 5 �r Z1 J��DI�� a(`��f i�C� �S z�12. �v��� q•�� <br /> , <br /> ' •qGN1IEC10A0lSIONER M4L�OORES4 Cltt 21P PNONE <br /> ') <br /> ;� OEN MLCO���S�����M�IL�OpRE��� ��. Il��^ �� `��Liv v�iONE ( IIGENSE• <br /> A I '.T/� /1�/�[C' ♦� <br /> /l l i� [/ [�__ / JClI ]/1 <br /> � MECNANiL�LCONiReCTOfl M.11L�DORESS GiIY LiP PRpNE 131Q �SE• <br /> i `��J 1,-,5� <br /> . PLUMB�NOCONTR�CfOR MAIL�COAE55 GiTY IiP PIIONE L�CENSE� <br /> aU��-s�� <br /> � CL�SSOFWORN <br /> I ❑ NEW ❑ ADDITION � ALTERATION ❑ HEPAIR ❑ DEMOLITION ❑ WOODSTOVE/FqPL.INSERT ❑ BUILOING fiELOCATION <br /> .I WLV�T�ONOfWOAN�C0�9111iMRENUL5P�U5L�BOH1 <br /> �� �J <br /> � <br /> OE6CRiBE WORN <br /> � � <br /> � U9E Oi BUILDINO I <br /> + I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS AP• <br /> �� PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALI <br /> d lEO�LDESCRIPT10NOiPROPENIV�SNOWN9ELOWON�tT�GMfOURCOPiE51 PROVISIONSOFIAWSANDORDINANCES60VERNINGTHISTVPE <br /> OF WORK WILL BE COMPLETE�WITH WHETHER SPECIFIED HERE- <br /> � �oi—e�oc�_or INORNOT.THEGRANTINGOFAPERMITDOESNOTPRESUMETO <br /> J �c GiVE AUTHORITY TO VIOLATE Oli CANCEL THE PROVISIONS OF <br /> a �� ANYOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. . <br /> SIONATUAE OF CONiRACTOR OR AUTHORIZEO AGENT �RTE <br /> ; �x �-�� <br /> PROJ[LT�DDRESS �PPUG�NiS CItY BUSINE55 UCENSE NO <br /> '1 � <br /> .� PLUMlING MECHANICAL <br /> 1 NO. TYPC OF FlXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WIITER CLOSET(TOILET) AiC-A/NNDLG UNITS-H P. <br /> �� BATMTUB REFRIGERATIONUNITS-H.P.EA <br /> i <br /> ,� UVATORV�WASH BASIN� BOILERS—B.T.UIH P. <br /> � SHOWER GASFiPEDA�C.UN1T5—B.T.U. <br /> KITCMEN SINK d DISP. FOPCED�IR SYSTEMS—BS.U. M EA <br /> d DISMW�SHER WALLMEATE1iS—B.T.U. M <br /> :� <br /> 1 UUNDRV TRAY UNIT MEATERS—B.T.U. M � <br /> i CLOTMES WASMER EVAPORATIVE COOLERS <br /> � URINAL CLOTHES DpYERS <br /> DRINNIN6 FOUNTAIN VENTIUTION FAN <br /> � FLOOH DRAIN RANGE HOOD <br /> 1� <br /> � BACKFIOWPREVENTERS WATERMEATER <br /> � ROOF DRAINS—N��NLEA�ERS WOOD STOVE <br /> SINN(SERVICE—BAR,ETC.) MEfAL FIREPUCE 6 CHIMt:EV <br /> �+ FIREPLACEINSERT <br /> HEATPUMP <br /> OAS PIPING <br /> E%NAUSTFAN <br /> I <br /> � SUOTOTAL f SUlTOTAL <br /> � PERMIT f �Kp� <br /> TOTALF[E f TO�ALfEE <br /> 7 <br /> � lRONT SETB�CK RE�H SETB�GK SIOE SETB�GK 7LAN CMECK t1UMBER FEE HEGEIPT NO. <br /> i USE 20NE LOf ANEA VAC11Ni 51TE FEES VALUATON FEE <br /> I ' OYES ONO ' � � <br /> TYPEOFCONST OCCUPANGYGROUP NO.OFUWELl�NOUNIiS BU�LDING S <br /> � PLUMBING <br /> 512E OF BLDU ND O�SIORIES M�X OCG.LOAD <br /> MECHANICAL <br /> OTHER <br /> FIRE SPRINKLERS REOUIFED O YES ❑ NO <br /> STATE BUILDING SURCMARGE <br /> STATEENERGVSURCHnRGE <br /> •NPLiC4LON�CC B� PL�NSCNECKEOBY �PVR.FOfiiSSU�NCEBV <br /> PUBUCWORKS <br /> :f <br /> TOTAI <br /> i <br /> j PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING ALL <br /> PROPERTV LINE LOCATIONSAND FELATED EASEMENiS. <br /> 1 <br /> ...c. -rr -� • - ... . ._.. . <br />