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QPPLICATIOk_ FOR C�NS't'RUG'TION PERMIT ""'"'" <br /> TO BE COMPLE' cD IN INK—PLEASE PRINT � <br /> rirv a <br /> everett I HEATINGSYSTEId JGAS JELECTRIC J _ � <br /> BUILDING DEPARTMENT �------- -- <br /> 25` 8810 <br /> DEMOLITION COMBINATION BUIL�ING MECHANICAL PLUMBING _ _ SIGN <br /> •;14 MMIRODII[55 �'�. '�:, r�•.,•� <br /> % � � / z�z ' 9[:L S' <br /> rfH1C wltC/AM� ��U ^ SeGl�_4 Sf� A'✓{ �� — — _—__ _ . <br /> ,:,.���t MahAeoNE95 crtv Z�r r��psf <br /> <R�,-.IaiCC10RDE51GNFR A�>RADDRF55 Gli� 21P PHJNE <br /> G[NEN4LCONTBPLIOH MML�DOFC55 ciiv IM ���ONE iKENSE/ <br /> !•LP�.1NiCAl[CON'1RAQ011 M1IAILPODR.EI55 LitY �I�P q �'���':L I�CENSE� <br /> � n�"� N-��[.��uC�1� 31/U•HiL� �UP !/I �I_l���_�� _ NOr�✓� /�3 /[L <br /> �y� cllitr�01NGCON1RPCiOR RIMLADDRESc LIIY Zi� e'l1�JC LICENSEI <br /> A �1 x -- -- <br /> �^ � � anssorwonK <br /> a �CiNE1N ADDITION ALTERATION REPAIR DEMOLIT:ON WOODSTOVE�FFPLINSERT BUILDINGRELOCATION <br /> t�� �' <br /> y �N // �M� cot�taci r[asor+nrvo vHonE r+o <br /> �'C O t U'l1RACt PRICE OF WORN � {/ VV — <br /> y '� CFSCnIpE WORR ANDSOWqE f00tAGC I,'rv��I'V'FID <br /> `tl N'il �' fMn. �'W'y-� n�n — <br /> fA H <br /> siaorosEouseor i�io� �: I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> H �.' I APPLICATION AND KNOW THE SAIdE TO BE TRUE AND COPRECT.ALL <br /> o --�' � �4y PROVISIQNS OF LAWS AND ORDIIJANCE.�GOVEPNING THIS TYPE OF <br /> O N d ii�:n�oe .niatior+orraorLarr,sirowueaowonnriea��ouaeoaiesi yrORK WILL BE CO�dPLETED VJITH WHETHER SPECIFIED HEREIN OR <br /> H �C �,,, _ e,ocK oF NOT. THE GRANTING OF A PER�AT DOES NGf PRESUME TO GIVE <br /> �� � AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> p.� G OTHER STATE OR LOCAL LAW REGULA7ING CONSTFUCTION OR TH[ <br /> Z y T, — PERFORIdANCE OF CONSTRI CTION.THAT I Ald AUTHORIZED BV THE <br /> [ <br /> r M y OWNF.F OF THIS PROPERTV TO PERFORM 7HE WORK FO � <br /> APPLICATION IS L1ADE ��ND I COtdP�Y VJITH THE STATG <br /> C7 C/J - CONTRACTORS LAW tB27 RC,:TND�96 2''J PJAC. <br /> � �� � SIGNn1UR[O�CO'�innCl:,�ouA�ll�...l'.,'c�n�.t.. [nll <br /> �� X� �' - - <br /> o� , .��;,,,�(} � •� ,_ <br /> JC4'�W✓5L a�i�uGm� -�.r.rtr ous� � !. . .:,� +.ss r.n�:i_ <br /> � V�II)� 1 � .: — <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR I7EM FEE NO. TYPE OF EOUIPMENT FEE <br /> Y�ATER CLOSET�701LET) A�C-A HNDLG UNITS-H P _ __ <br /> � --- � f-ORCEDAIRSYSTEh1S-�.� 1 M EA. _i_ <br /> BATHTUB — <br /> I �� _ LAVATORVIWASHBASIN) - _— UNITH[ATERS-B.T.U. M _ <br /> SHOWER CLOTHES�RVERS <br /> KITCHEN SINH 8 DISP V[NTILATION FAN _ <br /> DISHVJASliER RANGE HOOD _ <br /> � LAUNDRVTRA{ � WAT[R HEATER _. <br /> I �— � CLOTHES WASHEF _ WOOD S70VE ___ <br /> URINAL METALFIREPLACEB CHIMNEV <br /> DRINKiNG FOUN7AIN FIFEPLACE INSEflT _ <br /> � <br /> FL0017 DRAIN HEAT PUfdP . <br /> I_ � BACKPLOWPREVENTERS y- GASPIPING _ <br /> �� FOOP ORAINS-RAINLEADERS E%HAUST FAN __ _ <br /> SINK(SERVICE-BAR.ETC.� -�� <br /> .a—' - __ — - <br /> ISUB TOTAL 5 ; SUB TOTAL g 3<� ' <br /> �1_�j _ __.________PERMIT S�—T . PERMIT 5 —�__ <br /> ��b� TO7ALfEE 5 TOTALFEE 5 Y'Y � <br /> FOR OFFICE USE ONLY: <br /> �uZYI�r�04Ck � ��f���SEiPACH SIpE SEIOACN �LP4 CHECK 1lUtAEEF �I L NCCEIPI Np <br /> -�- - VALUA710N FEE <br /> usr,zorm �ornn�n vncnr�rsne FEES <br /> BCI�OING <br /> ivPFOftONlSAIIOWaP1E 1�Pt0�COH5tI.CiWL xwr�xcr xoaunb..iY�uv�= ----------— - -— � — , <br /> �,"0pv pLUM�ING <br /> sizE Of PLOG NO OF S10HIE5 BASEAIENT MECHANICAL y�' — <br /> nLCUMNLYLOAO fIPESFNNKLER5RE0'� MEtGHTI�MItPiION ADDI110NALPLANCHECN <br /> OTHER <br /> _ ____� <br /> ��EASDN FOR SPRINKlFHS i <br /> STATE OUILOING SURCHARGE <br /> __. ___.—___—__—._ ._.___ _ .. -- —__ ... <br /> rnnvtnv n�mani��•uwmav �ITYOFEUERETT PUDUCWORKs <br /> � LOCALSAIES � �� <br /> TAX CODE IS 3105 T�TA� v 1 <br />