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,._.. <br /> -�lc..v� �1� �a�3 '-= <br /> �'� ;� rr„-t�PLICATION FO(����— � ���,�� <br /> �� cmoro�� CONSTRUCTION ��, t �I 0 <br /> ; everett PERMIT �� <br /> � BUILDING DEPARTMENT TO BE COMPLETED IN INK • PLEASE PRINT <br /> ? 259•8810 <br /> � <br /> y ❑ DEMOLITIO i ❑ C M INATI N UILDING ❑ MECHANICAL O PLUMBING ❑ SIGN . <br /> � OWHER �iL D [55 <br /> cirv ziv PNONE <br /> ; --� 2 �5"0`� �.�� �/40� 8� �/l�.�c; 9&� Yt� � <br /> ' �RGNIfEGTO DlS�GhEA M�IL 0 55 <br /> �,r,7-.u,� <br /> �t7. � SJFn�, �P.+�.. �lf�390 r£�� =7�0 <br /> � ENERAL GO iB�L OR MUL�DOP[55 Gtt bn ���ONf I.�CCrvSE• <br /> ' �7 . .� i. //�U `�r�`�✓ C�i%�cr�uc., 9�0�1 5453 'y'I��O <br /> � ��NIULCON1P�CiU�1 M�IL�DUNE55 G� 1 nl��/ 4��_��E SE <br /> K <br /> - PIUMBIHbCOM�F�G10R M.1i1.�OD�E55 C t Z P �./ P D E CEN E• <br /> � <br /> ' CLAS50�WOAN <br /> � �Ey,/ ❑ ADDIiION ❑ ALTERATION ❑ AEPAIR ❑ DEMOUTION ❑ WODDSTOVE/FRPL.INSERT ❑ BUIIDING AELOCATION <br /> �ro rwon.�cosiorM•anuisrws��noai � <br /> va <br /> � oescni won� � � <br /> use o�eu ne ` I HEREBY GERTIFV THAT I HAVE READ AND EXAMINED THIS AP� <br /> �� n PLICA110NANDKNOWTHESAMETOBETRUEANDCORRECT.ALI � <br /> iea.ioescnir*ioNocoaor nrsNowr+aeiowon.n.c��ouncor�csi PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE , <br /> � OF WORK WILI BE GOMPLETED WITH WHETHER SPECIFIED HERE I <br /> ' �o�_B�o�„__oF IN OF NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> � GIVE AUTHORIT'! TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANV OTHER STATE OF LOCAL LAW REGULATING CONSTRUCTION <br /> , OR THE PERFO M CE OF CONSTRU TION. . <br /> . S�GN>IURF Of M'I iGR O�AUINOP12E0 RC f1T OAIE <br /> X, ' � ��' /� ff <br /> PAOJEG1�OOUE55 /J AP f.nNfSG�vBU51NF55UCFN5F��0 <br /> / /� <br /> �ZLp — ��% d� S _ �id<� <br /> PLUMBING MECMANICAL <br /> NO. <br /> TYPE OF F�XTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> � W�TER ClOSET�TOILET� A/C—/.iHW�LG UNIiS—N P. <br /> REFRIGENATION VNITS—H P EA. <br /> � B�TMTUB . � <br /> UVATORv�WASH BASIN� BOILERS—8.T U/N P. i <br /> � GRS FIREO A.C.UNITS—B.T.U. <br /> SHOwE a <br /> KITCMEN SINK e DISP. FORCEO p�R SYSTEMS—0 T.U. M EA. <br /> . WAILHEATERS—BT.LL M <br /> �� D�SHWASHER <br /> � UNIT HEATERS—BS.0 �"� <br /> � UUNDRV TPAY <br /> � CLOTHES WASHER EVAPOPAiIVE COOLERS <br /> . CLOTHES��vERS <br /> UR�NAL <br /> � VENTILATION FAN <br /> ORINI(ING FOVNTAIN <br /> � FLOON ORAIN <br /> — NANGEMOOD <br /> BACKFLOW PREVENTERS WATER MEATER <br /> ' HOOF ORR�NS—RAINLEADERS wOOD STOVE <br /> � SINN�SERVILE—BAR.ETC 1 MET�L FIREPLACE S CMIMNEY <br /> ' FIREPLACE INSF9T <br /> � HEAT Pl1MP <br /> � GAS PIPING <br /> � E%HAUSTFAN <br /> I <br /> SUlTOTAL f SUBTOTRL <br /> � PERMIT f PERMIT <br /> ' T0Tl1l FEE f TOTAL FEE � <br /> r RECEIPT/N�O <br /> � VLANCMECKNUMBER FEE Z� TU 1—�� <br /> � INONLSETB�Ch AURSELB�CN SIDESEIBACN p. /l �— <br /> , d � ` <br /> � use zor+e �or enee v.ceHr srte FEES VALUATION FEE <br /> . P�3�, orEs on0 BUILDING 5 <br /> /� <br /> � TYPEOFC�O $i OGCUPANCYGf�OUP MOOL�wEIIINGUNIiS <br /> � , �/ ..� M �/ �}� PLUMBING <br /> y <br /> SiZE O�BIOG YO OP S10PiE5 Mn% OGL LOAD MECHANICAL <br /> �sfoO SF � N Q <br /> OTHER� <br /> � FIRE SPfiINKLERS REOUIRED ❑YES'�(NO STATE BUILDIN:SU�CNAi7GE <br /> STATEENE�GYSUPCNARGE <br /> � nr+i�uc�.nOrvncr. o� �leNSC�iECrcE00V nrrqroniSsu�HCEar pUBLIC\YORKS <br /> � � � TOTAL <br /> ���•v <br /> PROPERiY OWNERS ARE RESPONSIBLE FOR DETERMINING ALL <br /> PROPEFTY UNE LOCATIONS AND RELATED EASEMENTS. <br />