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� �)/��-� <br /> t„-PPLICATION fOh-� ��«<„ <br /> �^.E»,°��° CCINSTRUCTION 0 . <br /> cin or <br /> everett PERMIT <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK- PLEASE PRINT <br /> 2ss-ea�o <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHAN�CAL ❑ PLUMBING ❑ SIGN <br /> cnr vn, m�orrt <br /> —.-- -�� .,.,,�33 T � A�E�� qf�o i a,��-�3� <br /> �V�n � ��-I ��� �s �I I , I � <br /> ���. s��, �•��„�,� <br /> •ncNncc�����'�s'u"��-u� <br /> �:nt )u� r��Ov[ uC[NSE• <br /> 6FNEIUICONfn�CtO� M�R+�I)�fSS <br /> GIY /�� �' ' ������� UCENSE•��f <br /> M�IL�OORl55 nn�.. 1 � ^'T7�A v� ' 1 �//r�-y�u" <br /> MIf14N?�l CON1O�GfOp "� � /� �i��� �Qh�� 9qQ r���L�x v'�l. ^/ /�j�) Ftw•_•••�.� ���� <br /> ���1�"fl lru.� C.'Q.s �1 Il1/�1 <br /> - qilY )if 1V�ONt UCEIISE• <br /> C���p LDIlf1[.':G <br /> Pluu9iR0 CON�1K�On <br /> LLi�550f N'O�K <br /> ❑ NEW ❑ �DDI110N ❑ ALTE�7ATION ❑ �7EPAIR ❑ nEMOLIIION ❑ �YOODSIOVE/FRPLINSERT ❑ BUILDING PELOCA110N <br /> vuwnoH or won.icocr.�r u�iva+�s n�us i+non� <br /> U[sCmOl wOnK ^. �y�/ �—n /'. J-p i1 <br /> �_ Gf.l_I� � � ��a U ��1C_LA��__ <br /> .J�/ �1(A.l�l <br /> use or no��+c � � / I HEREBY CERTIFY THhT I HAVE READ AND EXAMINED THIS AP• <br /> �� ��C�e`n — PLICATIONANDKNOWTHESAMETOBETRU�ANDCORRECT.ALL <br /> �E:�,ioescA,�no�+o�Paoncnirisr�owr+auowon ir c rou w es PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERF� <br /> ,o�_eioc�—o� IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE �U71iORITV TO VIOLATE OR CANCEI THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PEFFORMANGE OF CONSTRUCTION. � <br /> $IGNAIURE O�GONIRACt O� iM f11ZF.0 AGEN1 pAiE <br /> X 'f�_ 5 �1d"� <br /> nnrucer�rscitr 5i�+ Ssucvis[�� <br /> vno�ca.00r+ess � <br /> MECHANICAL <br /> PLUMBING 7ypE OF EQUIPMENT FEE <br /> T/VE OF FIXTURE OR ITEM FEE NO. <br /> NO. q�C—A�HNOLG UNITS—N P <br /> W�TEP CLOSET�TO�IET� pEFRIGER�TION UNITS—M P EA. <br /> BATNTUO � <br /> BOIlERS—8.T 111H P <br /> U�ATORY(W�SM BI151N� <br /> CAS FIHED A C.UNITS—8 T U. <br /> $HOM/ER FORCEO PIR SYSTEMS—B T U./L1pM� <br /> NITCHEN$�NN A OISP M <br /> W ALL NEATERS—8 T.U. <br /> DISHWASMEN M <br /> UNIT MEATERS—B.TL <br /> LAUNORYTR�Y <br /> EVPPOnnTIVE COOLERS <br /> CLOTHES W�SMEF CLOTHES ORYEPS <br /> UA�N�L VENTILAT10�FAN <br /> pRINNING FOUNTAIN RqNGE MOOO <br /> FLOOp DRRIN ` <br /> N'ATER NEATER <br /> B�CKFLOW PREVENTEAS �yppD STO�E <br /> ROOF DRPINS—�AINLEADEF$ M�q�FIREPIACE 6 CMIMNE� <br /> S�NN�SENV�CE—BAR.ETC� FIREPI/10E INSERT <br /> NEATPUMP <br /> CPS�IPING <br /> EXHAUSTFAN <br /> SUBTOTAL <br /> SUBiOTAI f <br /> p[RMIT <br /> PERMIT = <br /> TOTALfEE <br /> TOTAL FEE f RECEIPT NO. <br /> -"— nE•nseie�ce sioescto�ee <br /> � FL/N CHECKNUMBER FEE <br /> 1 PONi SE101Ctl <br /> ❑SE ZONE LOI nREA VnC�NT SIIE <br /> FEES VALUATION FEE <br /> mE5 orv0 BWLOING S <br /> NO O�OWFLLIN i UNI15 <br /> rvcEo�cOHsi oc[uvervcrcnocv p�UMBING <br /> r�o or srouies M�x oGc �oso <br /> SKE or BLDa MECHANICAI. <br /> 01HEfl <br /> FIRE SP�7INKLERS REOUIRED U YES O NO 5'�ATE BUILDING SURCHARGE <br /> S7niEENERGYSUACNARGE <br /> •pG�iGF110NACC8v �`Ll115CNEG4CDOY <br /> �rrnroni55U�Hcter pUOLICWORKS <br /> TOTAL <br /> pROPFRTY OWNERS ARE RESPONSIBLE fOR DETERMINING A�� <br /> PROPERTY! '"1E LOCATIONS AND RELATEO EASEMENTS. <br /> racs,n.,...i::. . .:.i^-. ' . . . . . . . . .. . � <br />