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� <br /> � ANPLICATION F'OR� <br /> `".E"""'" CONSTRUCTION �ve <br /> CITY OF <br /> everett PERMIT <br /> j BUIIDING DEPARTMENT <br /> � 259-8810 TO BE COMPLETED IN INK• PLEASE PRINT <br /> � ❑ DEMOLITION D9�COMBINATION Cf BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> ip�yN�q M411 PDORL55 CT' 21P oqON[ <br /> i �11 �lc� �Ui 1�7C3 �Yy,�.�P�� G� E�J��e� 9��03 �S3-S�7�o <br /> ARCNII[L�OROFSIGNEH MFIlA00NC5S Q� .M1` PnONI <br /> I �Q�SS'irA) �pSK'til �.��l9c�ckJ L�Ic�f� 9F1�? �s 5= 3,�LY1 <br /> I GENERA. LONiRAClO 1 �/�-�� 1,�A�55 (� /�''� G�� '`�ZO' f /y�J'r��pNf`/�/' ��G[NSF• <br /> I �f�.11nNII.A�RACi(1F / ,//�/Il�/ rLJJ.i�ES�\/ �J! LA/� r� /��!] �/// �CJ / MU/VY�� / <br /> I r <br /> � <br /> � - <br /> PLUMBiN.CONfN4LfOR MAILA�DRL55 CrtV LI` 4�i�ONE uCLNSE • <br /> C1�550�WORr; <br /> � NEW ❑ ADDI710N ❑ ALTERA710N ❑ REPAIR ❑ DEMOLITION ❑ 1400DSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION_ <br /> WlU�T10NJfWORaiC OfAIUCRIAL5VL11JLAB0�1 � <br /> �� �� -�a� <br /> ocs rwoaK <br /> �� � � <br /> use ov ouaoinc <br /> n __�.i���n ^L I HEFEBV CERTIFY THAT I HAVE READ AND E%AMINED THIS AP- <br /> i �'��, ,7 PROVISIONSOFLAWSANDO DNANCESGO ERMNGRHSTYPE <br /> � cAIOESCRiP11pNO�PRDP[RivISNOWNBELOWORn11ACMfGLRCO��ES <br /> �n OF WORK WILL BE COMPLETEO WITH WHETHER SPECIFIED HERE• <br /> �oi�Le�ocwL4=or ��� IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE Ofi CANCEL THE PROVISIONS OF <br /> ANYOTHER STATE OR I.00AL LAW REGULATING(:ONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIGNFTUFE OF�ONiliAfiGR OR AUTHORiZED AGENi p�7E <br /> � <br /> X <br /> PROJECi�ODRESS AP �- .,����� U Nf 511.C NSC NO <br /> � e <br /> i PLUMlING MECHANICAL <br /> NO. TYPE OF fl1ITURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER LLOSET�TOIIETI A�C—AiMNO�G UNITS—H P <br /> BATMTUB � REFRIGEPATIONUNITS—HP F�. <br /> LAVATORY�W�SH B�SINI �— �OILERS—B T U M P <br /> SNOWER GAS FIRED A C.UNITS—B T.U. <br /> IKITCMEN SINK 6 OISP FORCED AIR SYSTEMS—BS U. M EA. <br /> � DISHWIISMER � wALL HEATERS—B T U. M <br /> � UUNDRVTRAV UNITHEAiERS—B.TU M <br /> LLOTHE$WASMER EVAPUR.4TIVE COOLERS <br /> UNINAL CLOTHES�RYERS <br /> DRINKING FOUNTAIN VENTILATION FAN <br /> FLOOR URFIN '� AANGE MOOD � <br /> BACKFLOW�EVENTERS WATER MEATER �— <br /> NOOF DRAINS—RAINLEADERS WOO�STOVE <br /> SINI(�SERVICE—BAR.ETC 1 METAL FIREPLACE 8 CMIMNEV <br /> FIREPLACEINSERT <br /> MEATPUMP <br /> GAS PIPING <br /> E%HFUSTFAN <br /> SUSTOTAL f SUlTOT�L � �' <br /> PEPMIT f PERMIT <br /> TOTALFEE f �' 10TAlfEE � <br /> �Ao�+r SEtB�Cn aE�a SEiB�cK SiDE s[TB�CK - PIAN CMECN NUMBER FEE AECEIPT NO <br /> ��r ' ' �9 z sc� 3�3 �° I 55 <br /> use rone ior nau vncAr+t sm FEES VALUATIOH FEE <br /> ❑vcs�uo <br /> �7 BUILDING 5 6j S 7(0 0 <br /> TVPCOff,0Y5i JCC PRNCYGROUP NOOfOWF.LlI4GUNIiS <br /> �—A( �Z—3 Z 7LUM�ING C <br /> 512[O�oIOG NO Of$tORI[5 MA% OCC LOA� � <br /> MECHANICAL <br /> � �y� Z - t <br /> OTHER <br /> FIRE SPRINNLERS REOUIRED ❑ VES ?JO $7qTE OUILDING SURCHARGE <br /> STATEENERGvSURCHARGE ` <br /> dI�F�.�Lqini4air. lf� �'laNSC��EGK[D9V PPPRfOa155U<NGE�� ��� ��W��H� <br /> TOTAL <br /> �ti� �1�-..� <br /> PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING ALL <br /> PROPERIV LINE LOCATIONSANO RELATED EASEMENTS. <br />