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�� ��PLICATION FOk�=� <br /> ' ""`"'°`"" CONSTRUCTION °""°" <br /> " CITY OF <br /> � everett PERMIT e <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK- PLEASE PRINT <br /> � ❑ UEMOLITION O COMBINATION I�BUILDING ❑ MECHANICAL ❑ PLUMBING ❑3SCaN <br /> OWNER M�IL�DDRE55 (C1�TY ?IP PHONE <br /> � V J ^s� <br /> •RG ITECiOFOESiQNER M'1�00RE55 CIIV ZIG PNONE <br /> �� ,., <br /> GENER�L CONfR��fOR M�IL ADORE55 Giv (ip PI�ONE LICENSE• <br /> �AuAirw-f- �iN.�/ �'e2'itlt /0 9�3 .�..e! 9��90 .�39�,Ps�) .veoRic <br /> MECH�NiGLCONIRe�q M�R�pORE55 CI1V ZIP PHONE �ICENSE• <br /> /F�OA <br /> PLUMB�NOCONTB�CiON M,11L��ORE53 CiIV bP Pi�ONE LICENSk• <br /> CL�SSO�WORK <br /> ❑ NEW ❑ A�DITION ❑ ALTERATION ��EPAIR ❑ DEMOLITION ❑ WOODSTOVEIFRPL.INSERT �ILDING RELOCATION <br /> W L W 1iON OF WOAK iCOST OF M�IEHULS PW S l�BORI <br /> d�S.�DO -"= <br /> DFSC i E WOfiK / <br /> P...n �Q�Da�I .. MnL'< _ M �� <br /> use or awimr+a <br /> � I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> �� PLICATION AND KNOW THE SAME TO BE TRUE ANDCORRECT.ALL <br /> �eo��oesc vrw OFPROPERiYiSNOWNBELOWOP�IIRGNfOUfICOP�E51 pROVISIONSOFLqWSANDORDINANCESGOVERNINGTHISTYPE <br /> � F WORK WIL�BE COMPLETED WITH WHETHERSPECIFIED HERE- <br /> �orJ�e�oc�ov OR NOT.THE GFANTING OF A PERMIT DOES NOT PqESUME TO <br /> �: GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> '� tn .Qt BNYOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTION <br /> ' "bH THE PERFORMANCE OF CONSTRUCTION. <br /> � �_v '� , SIGN�TUR OF CONTR�CTOrI OF�UTHO EU AGENT pAJE <br /> i ` ` A <br /> � PROJEGi�00R 5 �PP�If.A iSC� BUSINESSL� NSENO <br /> � � r <br /> 1 � /n / � <br /> � <br /> i <br /> i PLUMBING MECHANICAL <br /> � NO. TYPE Of flXTUR!OR ITEM FEE NO. TYVE OF EOUIPMENT FEE <br /> � WATERCLOSET�TOIIET� A/C—A/NNOL�UNITS—MP. <br /> .� BATHTUB REFRIGERATION UNITS—M.P,EA. <br /> UVATORY�WASN BASIN) BOILERS—B.T.0/M.P. <br /> i <br /> 7 SHOWER QASFIREOA.C.UNITS—B.T.U. <br /> � KITCHEN SINN e DISP. FOFCED AIR SYSTEMS—B.T.U. M EA. <br /> d <br /> � DISNW�SNEN WALLMEATERS—B.T.U. M <br /> � LAUNDNY TRAV UNIT HEATERS—B.T.U. M <br /> f CLOTMESWASHER EVAPOPATIVECOOIERS <br /> i URINAL CLOTNESDRYERS � <br /> DRINKIN6 FOUNTAIN VENTIUTION FAN <br /> �' FLOOR ORAIN RANOE HOOD <br /> i BACKFLOW PREVENTERS WATER HEATER <br /> ROOF DRAINS—RAINIEADERS WO00 STOVE <br /> � SINK�SERVICE—B�R.ETCJ METAL FIREOLACE 6 CMIMNEV <br /> .� FIREPLACEINSERT <br /> � HEAT PUMP <br /> ' 6A5 PIPINO <br /> ; _ EXHAUSTFAN <br /> iU!TOTAI 3 lUOTOiAL <br /> � rERMIT t pL11M17 <br /> ! TOTAL fFE f TOT11L E <br /> I fRONiSEtBeGk PE�HSETB�CK SIOESETB�GK �LANCIIECKNUMBER E � RECEIPTNO. <br /> ., � Zn � G � <br /> a <br /> USEZONE lO1�RE� y�C�Ni51fE EES VALUATON FEE <br /> 1 OYES ONO <br /> tYPEOFCONST OCCUP�NGYGROUP NO.OFDWELLINOUNITS BUILOING S <br /> 3 PLUMBING <br /> I 512E O�BlDO NO OF SiORIE3 M�X OCC LOAD <br /> � MECHANICAL <br /> � <br /> OTHER <br /> � FIRE SPRINHLERS REOUIRED ❑ YES ❑ NO STATE BUILDING SURCHARGE <br /> 1 <br /> � 5*ATEENERGVSURCHARGE <br />