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� ' �1PPLICATION FG,� �� ����,�„ <br /> �^•E�'°'�° CONSTRUCTION e <br /> �Cltt OF <br /> � everett PERMIT <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK- PLEASE PRINT <br /> 259�8B10 <br /> � ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING A'�ECHANICpL �7 PLUMB'NG ❑SIGN <br /> : OWMER �.c�.5 p MPIL ��AE55 CItY 210 PMONE <br /> iTC2��3 ���" �-�'�r� !/�o�� :Sz�d�`'- sc BEcC��c.� r ,:.�-yo3t� _ <br /> ' �NGHIfECiOROlS�GN[R M�u�DDRE55 'I � �iLj 2i0 w�ON[ <br /> : .�iZrJES s�'OUG/����--ir�C� 6�3 W�w�j D�- v tlaUS`id�Jr �7705 p�.oNE ��_Ec�8p9E -5F2� s"3c� <br /> GEN[P�LCONLRn�IOR �[ C/'SA1 11l flR[$5 C���L� �/IQJud �� / ���_��O J G N/� <br /> TG 2 s��r4. �r��as�' c;�,� //�o-� �� ;V,� <br /> MlGN�NIGLCOMPnCtOq MAIt<OORE55 CiY ]��' P�NNE UCENSE• <br /> ��a,�On.. ,v� C.� . ZzU1q - 7o�-r��� sd€�..�� w� rb'r�32 57s=��b8 w��.sds,sr_n� <br /> - FWMBINiCONiR�L10R <br /> MAILADDRE55 f.11V Z�V PI�ON E IICENSE� I <br /> GL�S FWOAK <br /> . �Eyy ❑ ADDITION ❑ ALTERATION ❑ F7EPAIR ❑ DEMOL1710N ❑ WOODSTCVE/FRPL.INSERT ❑ BUILDING FEIOC�TION <br /> • - veiu�no or wanh.ico5i ur u�tf.nuts r�us��non��— <br /> So� <br /> p¢SCHiBE wOAn <br /> JT� P�/lT� �� F�h.L�'�cuE .•.1 LL TrU•J � en. (JG�./ 5 <br /> �, use F ew�o�nc . I HEREBY CERTIFY THAT � HAVE READ AND EXAMINED THIS AP• <br /> , .��,�� p�„�p-�,eL PLICATIONANDKNOWiHESAMETOBETRUEANDCORRECT.ALL <br /> LEO�LOESCA�Pt�ONO�PAO�[RtY1511OWN0ELON'OR�ITALNfOOPCU�iE51 PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPE <br /> OF WORK WILL BE COMPLETED WITH WMETHER SPECIFIED HERE• <br /> io�—e�oc�o� IN OR NOT.THE GRANTING OFA PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOIATE OR CANCEL THE PROVISIONS OF <br /> - ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFOFiMANCE OF(:ONSTRUCTION. <br /> SIGNn1UFE OI'COf� O�O�AUTHO�12ED AGENt DnTE�/—�Q ��� <br /> / <br /> •�/ . <br /> erri,`.• fiG1YpU51Nf.55UfL115EH0 <br /> PPOJECi�pDRE55 <br /> D2zn - 3'�ev� s� fi��e ��4 ; <br /> PLUMBING MECHANICAI �I <br /> Np, TYPE OF FI%TURE OR ITEM FEE NO. T'PE OF EOUIPMENT FEE I <br /> WATEP GLOSET�TOILET) AIC—��MNOLG UNITS—MP. <br /> BATMTUB PEFRIGEP�TION UNITS—M P.EA. , <br /> � BOILERS—U.TU/HP � � <br /> � UVATORY IWASM BASIN� <br /> SMOWER 6AS FIREO A C.UNITS—BS.U. <br /> � KITCHEN S�N1(6 OISP. FOPCEU AIR SYSTEMS—B T.U. M FA. 'I <br /> I DISNWASHER WALL MEATE�S—B T.U. M <br /> LAUNORVTPAV UNITNE/.TEAS—B.T.0 M I <br /> � CLOTIiESWASHER EVAPORATIVECOOLERS ' <br /> UNINAL � L CLOTMES O�VFRS i <br /> ' VENTIIATION FAN , <br /> ORINKING FOUNThIN �. <br /> FLODR ORAIN R�NGE NOOD i <br /> BACKFLOW PREVENTERS WATEq MEATER , <br /> � ROOFOPAINS—RAINLEADERS wO005TOVE � <br /> SINK(SERVICE—BAP.ETC� � METAI FIREPUCE 6 CNIMNEV � <br /> — FIHEPIACE INSERT <br /> HEPTPUMP <br /> � GAS PIPING <br /> E%HAUSTFAN <br /> SUBTOTAL f SUBTOTAL <br /> PERMIT f PERMIT <br /> TOT�IFEE f TOTALFEE <br /> ���UN15E10aCn �HRSEi9�CB Si0[SETO�CK <br /> ' PLAN CMELN NUMDER FEE RECEIPT NO. <br /> usE zone io�nnu yp�qNf S�IE FEES VALUATION FEE <br /> ares �iNo � 5 � <br /> OUILDING <br /> tVPEO�CONSi OCCUPANCVGf.OUP NOOLOWFLLINOUNIiS <br /> PLUMBING <br /> SKEOf9l�U NOOFS�OPiES MAKOCGIOA� MECIiANICAI <br /> OTMER <br /> FIRE SPRINKLEFiS REOUIRED ❑ vES ❑NO STATE DUILOING SURCNARGE <br /> STnTEENERGYSURCMPRGE <br /> APFlIC4IlON<CCf3V PLANSp1ECNE0B� APPpfOR155WNGE0� pUBUC�4'ORKS <br /> TOTAL � <br /> PROPERTYL�INELUCAiONSA DRELATEDEASEMENTISINGALL <br />