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I��Ev�rpn�n , .PPLICATION FOh, ���,�„ � <br /> ��n�F CONSTRUCTION e <br /> everett PE RM IT <br /> BUILDING DEPARTMENT <br /> 259-8745 TO BE COMPLETED IN INK • PLEASE PRINT <br /> ❑ DEMOI_ITION � COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> uW��[� AUII TOORtSS GIY tIP PIIONL <br /> 1 <br /> /�/ -i>,./ �,� r �=� �'�r f�.:�,,� ,, �� �,�.;iR�c /cs�, �frn� L 7/3 .�74'/ <br /> enr.�artcionmsir.r¢n n�nunnmu.ss �:nv �u� ruoru <br /> GEH[MI CON7MCTOR h1All TOf)fl[55 f.IIY ZIP 14iONC r � I ICLNSE• <br /> /� - �. � � �.5�� �(h.5'//,(,�{�%�S,f j.JClr� <br /> yniviti/S �nn1 iT. -JnIP .�s n n r �/% i/r z .3�. ,�i/�e c (G>i. 9s��_ �. <br /> MECIIANILAI LONiRACiOq M1IAiI �OI1B[SS CIIY LIP PIIONC IICCNSI:� <br /> PI.IIMBINGGONIR�CIOR AIAIt AppBLGS f.itY ZIP PIION[ tlC[NSL <br /> C1A550F WORR <br /> � NEW L7 ADDITION ❑ AL7EFFTION ❑ REPAIR ❑ DEh10LI110N ❑ WOODSTOVE/FHPL.INSERT ❑ BUILDING RELOCA710N <br /> �VAIy�710N OF WORN�COST QF AMTERIAlS P11151 ABORI <br /> �'�S ODD � <br /> pESG [ ORN � <br /> X , F� S', � � ' � <br /> USEOFBUIl01NG I HEREBY CERTIFY THAT i HAVE READ AND EXAMINED THIS AP• <br /> .S�iNb[C / �/L u•!/E PLICATIONANDKNOWTHESAMETOBETRUEANOCORRECT.ALL <br /> lEOALDESCPiPTIONOFPROPERI �SIIOWNOELOWOR4TtACNfO11RCOC�E51 PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> 7� OF WOFK WILL BECOMPLETED WITH WHETHERSPECIFIED HERE- <br /> ioi�e�oc�or �������`� ''� �� �9��� �"��� INOflNOT.THEGRANTINGOFAPERMITDOESNOTPRESUMETO <br /> GIVE AUTtIORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> .�d(p,C iN - i"D f e P�7 !:4f/.�rr�f� �Fda�.�'/» ANYOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTION <br /> OR 7-HE PERFOHMANCE OF CONSTfiUCTION. <br /> � ' �� - ' SNiNAl11HE Of'UNIHACION JR AUIIIORI2hU AGENT UAIE <br /> (�t // °f ���rs: ti1l.r �n' :SNd. � <br /> � '"' _,� X � �� <br /> �O ��/�,�/, `>! �� / � q Pllf NTSCI OOSIN[SSIIC[NSENO � � <br /> PROJEGTA DRE55 <br /> 3 '�2 E , a�1�C �� 1��E - <br /> PLUMBINO __'_____ ___._ _ MECHIINICAL _ __ _ _ <br /> qp, _TVPE OF FI%TUflE FEE _NO._ TVPE OF EOUIPMENT ____ ___FEE_ <br /> l. WATEfl CLOSET ITOIIED____ _ �O �_ .__ ._ AIR CONO UNITS-M P.EA. __ __ __ <br /> _� B4TMTUB ______�QO ____ REFRIGERATIOtI UNITS=M P. EA _ __ _ <br /> LAVATORY IWASH BASINI _1(2 ('� _'_' �OII.ERS-11 P EA. '_ <br /> SMOWER _ __ GAS FIRE[7 A C UN1T5-TONNAGE EA___ _ ___ <br /> KITCHEN SINK 8 DISP. __ C�_ ______FORCED AIR SYSTGMS_BS.0 M EA_ _ __ <br /> DISHWASHER _ OZ� WA�LIIEATERS-B.7.U. M__ _ _ <br /> IAUNDRYTHAY _ __ UNITIIEATERS-BT.U. A7 __ <br /> CLOTMES WASHER DU EVAPORATWECOOLEFS <br /> WATER IIEATER 7 CLOTIIES DRYEflS � <br /> URINAL __� VENTII ATION FAN _ Q <br /> DRINKING FOl1NTAIN RANGE HOOD _ ___jQ <br /> FLOOR OPAIN AIR HANDIJNG UNIT- C F.M. ____ __ <br /> VACUUM BREAKERS STOVE <br /> ROOF DRAINS-RAWLEADERS METAL FlREPLACE6 Cl/IMNEV <br /> SINK�SERVICE-BAR ETCJ WOO[15TOVE�FIREPLAC[INSEPT <br /> - - —! .ve7s-�H�Sex. — <br /> — — <br /> - - - <br /> -- _ SUB TOTAL --- -__�S dO _ __ _ __'___SIIB TOUL ______ s '___�� <br /> - -- PERMIT _t __ PERMIT___'_ _ <br /> ___ <br /> � _ T _ _'-_ <br /> __ ___ TOTALFEE __ i _____ry'� � _ _'___—__-'_-_'_"-TOTALFEE__'__---_s--___ ' _ <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> �RONISEip�CN R[ARSETOACH SiDE5Cf0ACK PLANCNECMNUAIBER /'PFyA)NC�IECNfEE <br /> ,..1.• J � FEC`���J:y'� NFCLIPINO����l/�� <br /> �O '� L� �i ,� � I����. � r� <br /> USC ZONE lOT ROE� VAGANI SIIE <br /> �� ) C) P�V[5 ONO FEES V�LU�TION FEE __ <br /> �. / � <br /> TYV[OFCONST OCGUPAN.GpYGIIOUP NOOFDN'ELLINGl1NR5 <br /> �� ;` � ' DUILOING S��j'�.� 3 f�, <br /> Si2EOFpL00 NOAFSTOPIES MA%OLGLOI,Of �v� <br /> L {'� / N•�f • P�UMBING (�.S W <br /> MECIIRNICAL 4C � <br /> FIRE SPRINKLERS REOUIRED I]YES NO o711Ea f � <br /> PENALTY . a�J B�J <br /> AVPI�C4110Nnf.0 �Y �'LRNSCIIECKEDOY PPPfI GOfiI55UAHGfOY — .�J <br /> � TOTAL _" __""__�1��_/_ � <br /> � �� .l G -__ ------ �- <br /> , <br /> i <br />