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i <br /> r.PPLICATIOf� FO�` everen <br /> '"'E""°`"° CONSTRUCTION O <br /> cin oF <br /> everett PERMIT <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK • PLEASE PRINT <br /> ❑ DEMOLITION /�COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> rnm�en r.m� anm+�.s cnv riv vHOHi <br /> �a � �/„�� � �L' � ,d /� c� � t.� �'i8z ui 33`� Sovz <br /> ARCNIiLf,iCNpt9�GNLN� MRiIFpDPC55 UiV :in nMONf <br /> GLN[�FLCOM1fR4LiOR AUM1.�O�AF.iS �:�R� IiP ���O4C JGfNSC. <br /> �/ , j �_ ��: .._ _ �:, � � _.� Y3Y-�oti2L'/,.,�SC7��i�1� <br /> M4.61PNiULCON1RGCiOq 1.141L AODRESS GLP ]iP P11pNF UCFNSC• I <br /> �'LU��BINaCOqLR<QOR MGIl4pDNE55 CrtT LP PIIpN6 IiCIJ15C • � <br /> CLA550�WO��. <br /> �\ryEW ❑ ADOITION ❑ AL7ERATION ❑ REPAIR ❑ DEMOLI710N ❑ WOODSTOVE/FRPL.INSERT ❑ BUIIDI�G RELOCnTION_ <br /> vA WF➢ON O�WCR��COSi OM1�Ia1CRiRL91'L115 LPBC� <br /> �`��}il�- <br /> oi scerec wonK <br /> usr o�o�mov+c � I HER[BY CERTIFV THAT I HAVE READ AtJD FXi�MINED THIS AP- <br /> PLICATION AND KNOW THE SAME TO BE TRUE ANDCORRECT,ALL <br /> imnioesc innoeorPaoacarvisnowr+oeiowoaniracr�rouncow[s PROVISiONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> G' ^ J r� OF WORK WILL 8E COMPLETEO WITH WHETHEF SPECIFICD HERE� <br /> io��o�oc�L(�_ov�� �" ��� INORNOT.THEGRAN�INGOFAPERRIITDOESNOTPRESUMETO <br /> GIVE AUTHORITY TO VIOLATE OR C.ANCEL THE PROVISIONS OF <br /> �� �fL_�'� �, � � ANYOTH[RSTATEORLOCALLAWREGULATINGCONSTRUCTION <br /> " OR THE PERFORMANCE OF CONSTRUCTION <br /> � � o� sicr+aiun=_er cuvraAct/ ��Fun�or,�cr.o acer�r oare <br /> r / � � <br /> X ! / - '.� I -' �'� <br /> PROJEC14pOHE55 4CP�iCANiSCIIVOU$IN t�LG:lllll4(� � <br /> ST r <br /> �uln<n / 1� ���c�.�/n �� l (T.n..� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR I7EM FEE NO. TYPE OF EOUIPMENT FEE <br /> '� WRTERCLOSETITOILE7� - A;C-AiHNOIGUNITS-HP <br /> BATHIUB `T) � REFRIGERAiIONUNITS-IiPG. <br /> LAVAiORY�WA5H8ASIN1 �; � BOILERS-OTU�HP <br /> � SMOWER - GFSFIREDAC UNITS-BT.U. <br /> KITCMEN SINK S DISP - FORCED AIR SVSTEMS-B T U. M EA. <br /> � OISH\VASHER - H'ALL MEAT[HS-B T U. M <br /> LAUn�RY TRAV UNIT HEATERS-��U M <br /> CLO''MES WASHER EVAPORATIVE COOIERS i <br /> URINAL / CLOTMES�RYERS 4 J <br /> DRINRING FOUNTAIN � �ENTIL\TION FAN 1 <br /> FLOOpDRNN AANGEHOOD <br /> BACKFLO\VPREVENTERS WFTERHEATER <br /> ROOF OPAINS-RAINLEA�ERS �vOOD STOVE <br /> SINK ISERVICE-BAR.ETC� METAL FIREPLACE S CMINNEV ) <br /> FIREPLACE INSERT I <br /> HEATPUMV j <br /> GAS PlPlhfi <br /> EXHAUSTFAN il <br /> i <br /> SUBTOTAL f SUBTOTAL < � 'i <br /> ➢ERMIT f PERMIT i I <br /> TOTALFEE f � TOTALFEE - - i <br /> ��+pr:*5[�04Cr. aEa�SEiO�LK SiD[SEiO�Cn �IAH C CK NUMpE:I FE�/ G RECEIPT N���� <br /> 2� z� , <br /> c ' g8�l��lC��S `'.� ��5 <br /> "`.i �°"E �or''AE" ypCpNi SR[ FEES VALUATION FEE <br /> 7 YCS �NO //�//1 � � <br /> I�PL O�CONSi OCCIIPANCY CFOUP NO OF DWFlLI4G UNRS BUILDING � I J�rt`f L / � � <br /> ��iV �.3 I PWMBING `'(r �<1 <br /> ":E U�OI�G NO O(SiORI[5 MAe OCC lOAO ^ � <br /> /� r� ) �i)� / �� MECMANIC�L �L �IC) <br /> 7 7 �c � <br /> � i OTNER �c� � � � ��O �� <br /> FIRE SPRINKLERS REOl11RED ❑VES O STATE BVILDING SURCMARGE . <br /> STATE ENERGY SURCHARGE �, <br /> i.. <br /> >����.�c.nou ocr ev a�ar�sc��[cneo nr nrvn ron issu<Hct er � <br /> PUDLICWORKS C i <br /> � ' <br /> � ;/� /'_�i TOTAL ���A , <br /> PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING ALL <br /> PROPERTY LINE LOCATIONS ANO RELATED EASE1dENTS. <br /> � <br />