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i <br /> ; ,ME�ro,»� h,PPLICATI4N fOI� � <br /> CONSTRUCTIOh � '`� eY«en <br /> cin or O <br /> everett PERMIT <br /> BUILDING DEPARTMENT <br /> 259•eStO TO BE COMPLETED IN INK- PLEASE PRINT <br /> � O DEMOlIT10N ❑ COMBINATION ❑ BUILDING �MECHANICAL ❑ PlUM81NG ❑ SION <br /> � OWNER ��Il�[II1RC55 CI V )II �IIONC <br /> m�-, Cha,,,.�rs 500� ��ru,�- ,�vQr��` 48� ��3-1� <br /> I �RCNIfECIOAI�kS�OHE� M�II�DUfI[54 C�1Y SU' C��pNL <br /> OlNEP�llON1�1L10� M�iI �01V1I5G f.i�v IIP �4�ONL UGENSE• <br /> N (;II�NIf.�ICnN1N�I:111f� M�tl �(1pRLtiG [1�Y lIV I�IIONE LICEN$E• <br /> �Ci.ueu r�lr.� F�����li�- G �s=t-t <br /> PWMB�NOCUN +uon .un..nm�rss air rm mwHr uce c• <br /> CI�SSOf WOu• <br /> i ❑ NEW G �DOITION ALTERAiION ❑ �EP41R ❑ DCMOLIIION ❑ WOOUSTOVEiFRPLINSERT G BU�LDING RELOCAiION <br /> umor+or wn�o�cosi rn Meio�us ri.us�ennn� <br /> l�Qb.00 <br /> orsen�ee woia � � � - � 1 ^ A ` <br /> ' � "�-• CL�I � � 1 � �-�JU �-Y l4LLd�L�iJ <br /> � <br /> usc or eunoir�a ;'') I HER[BY CERTIFY TNAT i HAVE READ AND EXAMIIJED THIS AP- <br /> � }-!'�. PLICAT�ON AND KNOW THE SAME TO BE TRUE ANDCORRECT.ALL <br /> IEO�LDESCNIG�IONO��R01�EA�Y15��OWHBELOWOR�If�CNfOU�CO�IC51 PROVISIONSOFLAWSANDORDINANCEuGOVERNINGTHISTYPE <br /> OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br /> �o�—eioc�—or IN OP NOT.THE GRANTING OF A PERMITDOES NOT PRESUME TO <br /> � GIVE AUTHORITV TO VIOLATE OR CANCE�THE PROVISIONS OF <br /> ANVOTHERSTA7EORL0(:AIIAWRE�ULATINGCONSTRUCTION . <br /> OR THE PERFORMANCE OF CONSTRUCTION. . <br /> SIGNetUA--O��CONIRACi F R TNORIIEpRGENi pRTE <br /> � <br /> �( �. '/ � � � /�-�S� <br /> � I110JECl�ODnE55 nnvuL�NiSC❑ 9USiNC54liCLN5EN0 i <br /> ' '��OC.o �v� ; <br /> � �LUM/IN6 MECHAHICAL <br /> NO. T7!OF flIfTURE OR ITEM FEE NO. T/PE OF EOUIPMENT FE! I <br /> W�TER CL05ET�TOILET� A/C-AMNOIG UNITS-M P <br /> BATNTUO REFPIGERIITION UNITS-H P EA. <br /> IAVATOpY�W�SN RI�S�N� BOILERS-0.7 V/N P � � <br /> � SHOWER G�SFlREDAC.UNITS-B.T.0 <br /> � KITCNEN SINK 6 DISP FOPCED�Iq SYSTEMS-B T.LL�p��M EA. <br /> � DISMWI.SHEN WALLMEATEI75-B.T.U. M <br /> I UUNDRYTRAV UNITHEATERS-B.T.0 M <br /> 0.0tHE5w�5NER EVAVORATIVECOOLERS � : <br /> j CLOTNESORYENS � <br /> VNINAL � � <br /> ) OR�NKINCi FOUNTAIN VENTILATION FRN <br /> P.ANGE HOOD ' <br /> I. FIOOR DRAIN r <br /> d B�CNFLOW PNEVENTERS W�TER NEATER � <br /> � ROOFDRAINS-RA�NLEADER$ WOODSTOVE <br /> $INN ISERVICE-BI1R.ETC� MR�L fIREPIACE 8 CMIMNEY <br /> FIFlBF'LACE INSEPT <br /> HEATPUMP <br /> CRS PIPING <br /> E%MAUSTFAN <br /> i SUlTOTAL { SUlTOTAL <br /> PERMIT { iKRMIT <br /> TOTAI FEE f 10T11L FEC <br /> �aoNi5E1B�CK AE�55EiB�CK Si0E5[1B�CK ��A�LMECNNUMBEN FEE �RECE�PTNO. <br /> USE ZOnE io��Fc� y�C�NI SrtE FEES VALUATIQN FEE <br /> ❑vE5 ONO S <br /> nvEorcOr+sr occur•r�crcnour r�oorowF�un.unrts <br /> BUiLDiNG <br /> PLUMBING <br /> '3REO�BiDO NOOfSiDR�ES Mn� OLCIn�� MECMANIC�L <br /> OTNER <br /> PIRE SPRINKLERS REOUIRED ❑ VLS ❑ NO STAYE BUILDING SU�CHAf7GE <br /> STATE ENERGV SURCHA(iGE <br /> s�•riiren���.-�rirNSt��EGnmer nrrnroai5swneEBr pUBLICWOFK3 <br /> TOTAL <br /> - ----1—"— ��-- f ROPERTV OWNERS ARE RESPONSIBLE FOR�ETEFiMINING ALL <br /> �I�OPERTI LINE LOCP.TIONS AND RELATED EP,GEMENTS. <br />