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i _ , . <br /> '�,-.PPLICATION FO�r�' ���,�„ <br /> ' �^•E~�°"'° CONSTRUCTION O . <br /> cin ov <br /> everett PERMIT <br /> y � � BUILDING DEPARTMENT <br /> � y y 259-8870 TO BE COMPLETED IN INK- PLEASE PRINT <br /> o �1x <br /> y y y � ❑ DEMOLITION ❑ COMBINATION 6] BUILDING ❑ MECHANICAL ❑ PLUMBING ❑SIG <br /> t y OWNEA M1UR�O O N(5 5 CIiV Z�P <br /> rrwr+c <br /> k� � SiJDNDwt�sll COww�. 7615� � 7f�,tvs Sf_ 5ti��ht�..�5n `j,f'�`�U �S� -J'd'�/ <br /> y� � �{�{.' REL�UROkS�ON[Nn MAlL�O�R[55 CiI Y J�� P�10NC <br /> ( /Z9//�/�= /si:ia ����cv,Nv.u,: `��lb7Z `1d'/ ' = Gs(� <br /> � N H /��.6�t✓J(��N —(t��u�nr cirv t�n n��or�c ucer�se. <br /> IGfNEMy CONtNeCt011 M��lA00qE55 <br /> �r / " 1L / �' S�,.1J1 id'!.'J' �z t - d'/oo o� ve.�7Y G <br /> .��. "�� ; L( �I•W• �w��.. yC�.-L J(Cq�uGnrtqr iin n�or�E ucEns[. <br /> [s3 p � /' M.n.�oon[ss cnr <br /> � 1 MECN�N�GLCOHta� QB <br /> OH � <br /> `� �g n��i��oo��Ess c� r r o E cE sc <br /> PLUMB�NG CONIR�GION <br /> �Y (7 <br /> � y� �1 CLA550!WORK — <br /> �] NEW ❑ ADDIiION ❑ A�TERAT�ON ❑ REPAIR ❑ DE�dOUTION ❑ ��OOOSTOVE/FRPL.INSERT ❑ BUILDING AELOCA110N <br /> yy vew.�io�+orwo����osio�M��Enu�sriusunom <br /> g � �Siiu�,. <br /> C�'�" oFSCa�nE won. <br /> OC7y <br /> j� �•� � . L`Qlcj�/��L'�.Q� �tr/.•'L �S��iNJ �7nrc!' <br /> � y (p us[or ounoinn <br /> I HEREBV CERTIFY TfIAi I NAVE READ AND EXAMINED THIS AP� <br /> H O y � PUCAiIONANDKNOWTHESAMETOBETRUEANDGJRRECT.ALL <br /> LEG�LOESGAIPIIDNO��ROFE�tYISNOM'NOCLOWOA�II�C��fOUFCOPIE51 PROVISIONSOFLAWSANDORDINANCESGOVEFNINGiNISTYPE <br /> OF WORK WILL BE COMPLETED WITH WHEi HER SPECIFIED HERE- <br /> ioi--e�oc�c.--a� IN OR NOT.THE GRANTING OF A PERMIT DOES NOi PRESUME TO <br /> � GIVE AUTHORITY TO VIOIATE OR CANCEL THE PfiOVISIONS OF <br /> q(�k�A�F Lv� 3UCd 6Iac.L n^J�t'OSJr ANYOTHERSTATEORLOCALIAWREGULATINGCONSTRUCTION <br /> OR iHE PERFORMANCE OF CONSTRUCTION. y <br /> FL�r�?�� �q �(�1t�� S�GNR�UPEOfCON�R4C�O�iOfiAUIIIORIZEOFGENL 04iE � �3T1 , <br /> , <br /> X �v�7..`�:� � <br /> � Anruf.�NrS eilr eusirvf 55 Uee�l:E�. <br /> � PROJECTA� $� ��L �OG�L �l� w �� � • <br /> �� <br /> MECHANICAL <br /> PLUMBING FEE <br /> NO. <br /> TYVE OF FI%TURE OR ITEM FEE NO. T'PE OF EOUIPMEN7 <br /> q�G—A�HNpLG UNITS—M P <br /> '�1 '�, W�TEA CLOSET ITO�LETI <br /> BATHTUB NEFRIGEAATION UNITS—H P �- <br /> ' ' � fO1lER5—BTUiHP <br /> UVATOAY(WASH B�S�NI <br /> � SMOWEH GPSFIREDAC.VNITS—BT.U. <br /> FORCED A�R S�STEMS—B T U. M E1. <br /> '�' KITCHEN SINK Q DISP <br /> OISMWASHER WALLMEATEAS—BT.0 M <br /> ' � UNITMEATERS—OTU M <br /> LAVNORYTR�Y <br /> � . EWPOPATIVECOOIERS <br /> CLOTMES waSHER <br /> CLOi1�E5 D�VE�S <br /> 1 ' URINAL <br /> VENTILATION FAN <br /> nRINI(�NG FOVNTAIN <br /> ' � FLOOF OR�IN RANGE NOOD <br /> WATER MEATER <br /> BACNFLOW PREVENTERS <br /> ROOF DRRINS—RAIM�EADERS W OOD STOVE <br /> METAI FIREP��E 6 C��IMNEY <br /> '�; ' SINK�SERVICE—BAR.ETC� FIPEPI.CE INSE�T <br /> HEAT PL'MP <br /> f�' � GPS�IPING <br /> E%MAUSTFAN <br /> �I 1 � SUB TOTAL <br /> SUBTOTAL <br /> pERNI� <br /> �' VERMIT f <br /> I TOUL FEE <br /> ' — — TOT�LFEE f <br /> VLArv GHECR NUMBEA FEE RECEIPT NO. <br /> {RCNISEIO�C� (1E�115E�B�GK SIOESEIB�GM Tr�1 ���5 ^O� �� <br /> usE za�6 �o���e• vec�r�r srtE V / FEES VALUATION 7 FEE <br /> ; o.es��o eui�ou+c S D <br /> IYPC O�C0Y51 OCGt1��HLY GPOUP NO U�OW�G UNItS <br /> ' yy. N M�� PLUMBING <br /> �• <br /> � SKF O�piDO �+(� u�SIOIUES M�K��� ���� MECH�NICnL <br /> : /2 X!(o CrL�/oP �� � �•'`�" <br /> OTH[A <br /> FIPE SPRINKLERS REOUIRED ❑YES �NO -- STnTE BUILDING Sl1RCHAf1GE � <br /> STATEENERGYSURCNARGE <br /> , �VPULA�ION�CCB� ovrvste[cKEoer ��F�� rOni55Wr+ceBr pUBLICWORRS <br /> �^ IM � � L �G TOTAL <br /> I�\ 1 <br /> PROPERiY OWNEPS AAE t7ESPON5IBLE FOR DETERMINING AlL <br /> � PROPERTV LINE LOCAiIONS AND RELATED EASEMENTS. <br /> � . . -i ' ' _ -'r '� <br />