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hPPLICATION FOf. ���,�„ <br /> �^•Ew'°`"" CONSTRUCTION e <br /> an or <br /> everett PERMIT <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK - PLEASE PRINT <br /> 259•8810 <br /> ❑ DEMOLITION O COMBINATION ❑ BUILDING ❑ MECHANICAL �PLUMBING ❑ SIGN <br /> OWNEF <br /> n�nu ennniss r.nv zu� rnon� <br /> �2 t�t D��;,= �suc, G2urr�F�cc�2 •=�f�1��» A�ravi as 5- s avi <br /> �pGN11Ef.i 0(1 Dl51GN[e <br /> MAiI PpCHES 1 :�P PIIONL <br /> GENERALGONiP�LiO� <br /> I.1011 api�RC55 f.irv !IV VI�ONL IICLNSf• <br /> d W.rll`2 <br /> MEGUN�UL CONIA�f.IOq <br /> n1Ail PODRLSS (:IIY IIP PIIONC IICCNSE♦ <br /> PlU��BiN�GONtR�f.�O� <br /> M�IL AOD111.1'v �'�P� (U` I410NC 111:116E • <br /> L,.U{�.SSOf WOPM <br /> {�Y� hEW ❑ ADDITION ❑ ALTERATION ❑ ��PAIR ❑ 17EM01IIION ❑ WOODSTOVElPRPl.MS[RT BWl01NG RELOCATION_ <br /> yµplilONOF WONM�L05�O(M4IC111A15 PLIIS I.AF1qf11 <br /> Y ?J(J <br /> 0!5 RIBE WORM <br /> R Lc,u- Rd•t SrR�str �.ir= <br /> USEULBlliiOiNG I IIEREBY LEHTIFY TfiAT I HAVE READ AND EICAMINED THIS AP• <br /> . �, ' ' PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL <br /> �cc�iotscair NOFPPOPERiY15NOW o[�.owonnii•r.uiou��a'��+� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTIiISTYPE <br /> Of�WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br /> Lpt_—BLOCK�—OF INORNOT.TMEGRANTINGOFAPERMITDOESNOTPP.ESUMETO i <br /> GIVE AUTMORITY TO VIOLATE OF CANCEL THE PROVISIONS OF <br /> ANY OTf1ER STATE OR LOCAL LAW flcGULATING CONSTRUCTION <br /> OR THE PERFORMANCfr ONSTRUCTION. <br /> $IGNA7URE OI'CUNt1iA R Ofi AUiH)f11ZED AGENI ❑•�IC <br /> . � <br /> .5 QG�iC /�LLC � Ill.2l�1 . . <br /> nrri .er�rsr.nrnu. i.:sur.i si��o <br /> vnuecT�ooaess <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER ClOSET�TOILET� ArC—A���Nfll(i UNITS—N P <br /> REFRIGERATION UNITS—1�P EA <br /> BATHTUB <br /> �AVATORY IN'ASH BASIN� �OILERS—B T u�H P <br /> Gn$FIREDAC UNITS—BTU <br /> SMOWER <br /> NITCHEN SINK 8 DISP FOFCED AIR SYSTEMS—B T U M EA <br /> WAILMEATEAS—BTU M <br /> DISFIWASNEH M <br /> IINIT HEATERS—B T U <br /> LAUNDRYTRAV <br /> CLOTHES WASMER EVAPOAATIYE COOLERS <br /> CLOTMESDRYERS <br /> UNINAL <br /> V[NTILATION FAN <br /> ONINKING FOUNTAIN <br /> RnNGE��00D <br /> FLOOR DRAIN <br /> BACKFLOW PREVENTERS WATEF HEATER <br /> ROOF DRAINS—FAINLC-ADEFS WOOO STOVE <br /> SINK ISERVIf.E—BPP.ETC� METAL FIREPI.ACE d CHIMNEY <br /> �. FIREPI.ACE INSERT <br /> IiEAT PUMP <br /> GAS PIPING <br /> E%IIPUST FAN <br /> SUB TOTAL S �.� 'K.� SUB T0TI1L <br /> PERMIT f G U U PERMIT <br /> TOT�L FEE f �j UJ TOTAI FEE <br /> iRON15[iB�Cn REAR SE10�CN 5��[SE10�CH <br /> ' PLAN C11ECN NUMBER FEE PECEIPT NO. <br /> USE ION[ io�^�e� MLANI Srtl FEES VALUATION �E <br /> ;�ves i.u�o S <br /> OUILDING <br /> ttPCOFf.CNSi OCCIIPANCVGROUP NOOP�WEILiNG�IN115 <br /> PLUMBING IS C <br /> 5¢[or0ioc t�o ovsionrts n�ne nr.r. �.oAo MECHANICAL <br /> O7HEli � <br /> FIRE SPRIIIKLERS REOUIRED f.l VES ❑ N�7 STATE BUILDINc;SURCHARGE <br /> STATEENERGvSURCtiARGE � <br /> pP�IIC4ilOrv>Cf. P� PLANSCtlEGNEDOY /•�'�R (ORISSURIC[8� pUBLICWORN$ <br /> TOTAL �S � <br /> PROPERTY OWNERS ARE RESPONSIBLE FOR OETERMINING ALL { <br /> PROPERTY LINE LOCATIONS AND RELATED EASEMENTS. <br /> � <br />