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� <br /> r,PPLICAIi ION f01. ' ��«�„ <br /> ""`"ro."" CONSTRUCTION O <br /> urr ov <br /> everett PERMIT <br /> BUIL�ING DEPARTMENT <br /> 259•8810 TO BE COMPLETED IN INK- PLEASE PRINT <br /> ❑DEMOLITION ❑COMBINATION ¢'�UILDING O MECHANICAL ❑ PLUMBlNG ❑SIGN <br /> •un�non�ss cm ziv PMONE <br /> ow��A�l��� 1���'�,r-a) /��5� P���k�-� ����� 1�n/ ��*-r�l�i�� <br /> •PCHrtE[tOROESu:nEN M��I�OOR[55 CiIY I�P V�ONE <br /> l ��,� <br /> fiEMFR4 COHTP� OH M�II�IlOHC55 CI1V SIP VIbNI IiLENSE• <br /> M��;�,.�o�°a,�Ar��.r�,S 6�:o'r�55��l1a� l�l�' /Ll�uys�rc�s Z9��n lm�i�» �Ok(DE�i���s <br /> PLUMBINOCONiH�Gi011 w+n.�ooatss cnr zu� w�orr. ircurse. <br /> CU530f WONK�y <br /> ❑ NEN �c+ ADDITION ❑ ALTEHATION ❑ REPAIR ❑ OEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING REIOC�TION <br /> V�l piIONOI�WJ�OR�rtICO510fM�lERiALSPWSI�BORi <br /> �OF Ni 'OPM <br /> ' `� � � ��� L� <br /> use or�y���i�+c C 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP� <br /> {/.�)//� Y ILL L iO�SI '� PLICATIONANDKNQWTHESAMETOBETRUEANDCORRECT.ALL <br /> LEG�LOEY:RIPLIONOFPPO ERTY�S110WNBELOWONAl1�CMFOUPLOPIE51 PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> r OF WORK W�LL BE COMPLETED WITH WHETHER SPECIFIED MERE• <br /> io�..2—•e�oc�or�� � ��"� IN OR NOT.THE GRANTING OF A PERMIT DOES NOi PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIOPlS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATINGCONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. . <br /> SIGN�TURE OF GONiRACiGR OR RUL10R12E0 AGENI Ds7E <br /> O ,Qic�K F� Y/G X S�O <br /> PROJEGT�DORE55 �PPUL�NT9 GIiY BUSINESS LiCENSE NO <br /> PIUMBIN6 MECHANICAL <br /> Np, Tr►E Of FlXTURE ON ITEM FEE NO. TYPE OF EOUIPMENT FE! <br /> WATER CLOSET ITOILET� A/C—A/MNOL6 UNITS—M P. <br /> BATNTUB REFRIGERATION UNITS—N P.EA. <br /> UV�TORY�WASH B�SIN� BOILERS—B.T U.M.P. <br /> SNOWER �AS FIRED A C.UNITS—8 T.U. <br /> KITCMEN SINN�DISP. FOHCED AIR SYSTEM9—B T U. M EA. <br /> OISMW�SHER WALLMEATERS—B.TU. M <br /> LAUNDRV TRAY UNIT MEATERS—B T.U. M <br /> I EV�PORATIVE COOLERS <br /> CIOTMES w�SMEN <br /> URIN�L CLOTNES DRVERS <br /> ORINKINO FOUNT�IN VENTIIATION FAN <br /> FLOOH ORAIN RANOE MOO� <br /> B�CKFLOW PPEVENTERS W�TER HEATER <br /> ROOF DR�INS—R�INLEAOEPS WOOD STOVE <br /> SINN�SERVIGE—0�0.ETCJ METAL FIREPLACE 6 CNIMNEY <br /> FIREPIACE INSEPT <br /> MEAT P4MP <br /> G�S PIPINO <br /> E%HAUSTFAN <br /> fU�(OT�L f t�l�TOTAI <br /> PERMIT f KIIWT <br /> T0711L Ff! i TOT11L F[[ <br /> ie<mr5t10�Cn� NE4a5EtB�cK siDE5E1B�tN ��NL'HE NNUMBER FEE �4 RECEIPTNO. <br /> � � , � ' S � q " 43��0 <br /> usemnt io�.ne� v�eenr:��e FEES VALUATION FEE <br /> ,�A�,p <W f�. ures�a BUIIDING S <br /> fYPCOf i OCCIIPANLYGPOUP NOOFDWFLLINOUNIT$ <br /> �� �� � PLUMBING <br /> 9IE Of tlipG I NO Of SfORiES Msk OLL LO�D <br /> /�.lp � ,y MECMANICAL <br /> l � � <br /> OTHEfl <br /> FIRE SPRINHLERS REOUIRED ❑ YES �10 STATE BU SDING SURCH�RGE <br /> STATEENERGYSURCMApGE <br /> �YPI�UtION�ACC BY PlANSI'ME,,CJrcE00Y �PPR FORISGII�NGEBY pUBLICWOflKS <br /> . �AI� ' '^� TOTAL <br /> 019 <br /> PROPERN OWNERS ARE RESPONSIBLE FOR DETERMININ�ALL <br /> . PROPERN LINE LOCATIONS ANG RELA'i ED EASEMENTS. <br />