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�.�PLICATION FO1. ���,�„ <br /> '"'E"ro`"" �i�NSTRUCTION e <br /> �,n of <br /> everett PERMIT <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK- PLEASF.. PRINT <br /> O DEMOLITION Ll COMBINATION �BUILDING ❑ M'CHANICAL ❑ PLUMBING ❑ StGN <br /> owucn M�n aonr+css �( ���r zir c��or�c <br /> �i��l � <br /> .s� ��� '7�r�G��t�r cx ri�, .0 �-'�- tr�� 353 — o2`T7S <br /> ABCHIifL1ORl1f$IGNEN � MAII A11�. LSv Li1V ZIP P��ONL <br /> ffrfiR.1LCOHLB�LIOP r.un �nnness u ������Y tiV nuONC �.iCENSE� <br /> Mec nr�ie.ienr�ra.ero� r,i� <r�S` ��"toL ��! • .sCL.=�c.,�-�4c _%�i�5-✓ '3%r��I3/� �.L/'1�Aicc��23 D11 <br /> PWAIBINGCONIR4Ci(19 AIMI ApOR[55 ���Y 21P ���ONE IICENSE� <br /> Cl�55 OG W OIIN <br /> ❑ NEW ❑ A�DITION ❑ ALTERATION � REPAIR ❑ DEMOLI110N ❑ �4'OOD51"OVEh'RPL.INSE(iT ❑ BUILDING PFLOCATION <br /> VAt U�!ION Of\YOR�iLOST Oi NAIERUlS�'LUS I�BDRi <br /> � s�' — <br /> 0[SCNiBE WOHI< �� ' � . � � _ <br /> �i..n.�p � i l • . .._ _ <br /> us�au ��c I HER[BY CERTIFY 1�HAT I HA�AND ExAMINED ThIIS AP• <br /> J���� PLICATION AND KNOW 1-HE SAME TO BE TRUE ANDCORRECT.ALL <br /> ICQ�IOFSCRIPLIONOFdROP[RTVI�MOWNOELOWOR�lUC11I0UliCOP�E51 PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> OF WORK WILL BE COMPLETED WITH WHETNEH SPECIFIED HERE• <br /> ioi�e�oc�ov "% �� ' �'„` ' INORNOT.THEGRANTIP:30FAPERMITDOESNOTPRESUMETU <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> - ANY OTHER STATE OR LOCAL LAW 7EGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONS'RUCTION. , <br /> SIGNUURL OF CONINACiOR OR AUTIIOR12f 0 AGENT f14TE 3-��." �� <br /> X �y /i <br /> PROJELT�DDNE55 4PPl�UNTSLilY0t15WE55LiGt�1^uEHO �% <br /> ��0 a-P Z i r' : � <br /> PLUM8ING ' MECHANICAL <br /> NO. TNPE OF FI)ITURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET�TOILET� ArC—A/HNO�G UNITS—M P. <br /> BATMTUB REFRIGERATION UNITS—H P.EA. <br /> UVATORY INUSM OAS�N� BOILERS—BSLJH P <br /> SHOWER GRS FIRED A�G UNITS—BS,U. <br /> KITCHEN SINK 8 DISP FORCEO AIR SYSTEMS—B T.U. M EA. <br /> DISNW�SHER WALL//EATEPS—B.TL. M <br /> LAUNDRY TRAV UNIT MEATERS—B.T.U. M <br /> CLOTMES WASHER EVAPORATIVE COOLERS <br /> JRINAL CLOTHES�RVERS <br /> ONINNING FOl1NTA1N vENTIIATION FAN <br /> FLOOR OAAIN RANGE HO00 <br /> BACNFLON'PREVENTERS WATER HEATER <br /> ROOF DRAINS—RFINLEA�ERS WOOD STOVE <br /> SINK�SEFVICE—BnR._RC 1 METAL FIREPLACE d C1111ANEY __ <br /> FIREPLACE INSERT <br /> HEATPUMP <br /> CAS PIPING <br /> E%MAUST FAN <br /> 5UlTO�AL f SUBTOTAL <br /> PEPMIT f PEXMIT <br /> TOTAL FEE f TOT�L FEE <br /> �HOrvi5EiB4.n eGR5E10�C� SIDESRBACI( <br /> '— PLAN CNECK NUMBER FEE RECEIPT NO. <br /> usE zoHe ioi aee� v�cer�r srte FEES VALUATION FEE <br /> uvcs u�+o S <br /> BUILDING <br /> fYP[O[LONSf OCCUPeNGY GROIIP �i0 ]F 0\VFILING UNI/S <br /> PLUMBING <br /> 5�1E or'o�Dc r+o Or SiOPiES MFI( OCG IO�D MECHANICAL <br /> OTHER <br /> FIRESPRINKLERSREOUIRED ❑VES ❑ NO _ STATEBUILOINGSURCHARGE <br /> STATEENERGYSUFlCMAHGE <br /> <PPIICL�IONALC OY PLANSCNECI(EDOV APPB IJRISSUANGEDY p��BUGWORKS <br /> TOTAL <br /> PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING ALL i <br /> PROPERTY LINE LOCATIONS AND RELATE�EASEMENTS. <br />