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. _PPLICATION f04_ ���,�„ <br /> IME.v�pm� CONSTRUCTION O <br /> cm or <br /> everett PE R M IT <br /> BUILDING DEPARTMENT <br /> 259�BB10 TO dE COMPLETED IN INK • PLEASE PRINT <br /> ❑ DEMOUTION Il COMBINATION 13'[lUILDWG ❑ MECNANICAL fl PLUMBING ❑ SI6N <br /> o�a�n.n nw .nmii •. ._._—__'___—_.._ .__v.—_.____—ri'_.__._____ rnnvr -- <br /> �PL,��.���:y.a--_Fsr���_--- — ------ �.-�,��- -- .'t-�2Y <br /> •n�rliiLft Up PI 5�..• � r.up �P11�11`.I. :iIY .' � bP�I�'I12�111 <br /> � �1 - ----- ---- -- _ - -------- <br /> aunRy corau t,n ' w�i auu�n�s,f ��n :e� runru iir.EN,[. <br /> �ou��.�_�r-��{e�.f'o_Sill. P�-9�3_—.�a��_.-.-- --I�P1��-- ,�2Ylpv) Nioti�cn�� <br /> r.�Ifnw�C�irnHO Lro� nun .uuet�:. Cih :�r i�nnNl. I�f,[nsE. <br /> ________" _. _. _—.'_ _—____.___-___—_— <br /> PIIIMA�N4f0111Rt(Jflq IA�II �CP�.Ii. i]IV III• PIION[ IIC.CrISf • <br /> CI1550f KDNk .. . . � <br /> ❑ NEW ❑ ADDIIION �AL1EHAilON _ O_ ��6PAIH ❑ DhM�111110N _❑ WOUDSIOVE/FRPLINSERI ❑ dUIL01NG REI OCATION_ <br /> v.�wnnr�o.wnm�cnsrro raunu�isviusi.nnn� Op <br /> � G_LD_�2-- - ----- <br /> nrsCaet wnnx w � / • � <br /> Ihl.w ww�� � Na►��il�L- _�s ^-�- s�--c��.� ���k <br /> uti[or eun Dm, <br /> I R@BY CERTIFY TI/Ai 1 fIAVE READ AND EXAMINED TIIIS AP• <br /> PLICATION ANU KNOW TNE SAME TO BE TRUE AND CORRECT.ALL <br /> im��ucs[a�P*��r�nrr�,oiqurisr�owHnT��wun�i��<��rnuncorrts� PROVISIONSOFLAWSANOORDINANCESGOVEFNING7HISTVPE <br /> � � ./y �L� G'� CF WURK WIU_BE COMPLETED WITH WNETHERSPEGFIED HERE <br /> �o� a�octi�"d�� L- INORNOI� iHEGRANTIN30FAPERMITDOLSNOTPRESUMETO <br /> GIVL AUl1iOH1TY i0 VIOLATF OR CANCEL THE PROVISIONS OF <br /> ANY0711EF STATE OR LOCAL LAW REGULATINGCONSTRUCTION <br /> ---- OR IHE PERF09MANCE OF GONSTRUCTION. . <br /> SIu11�lUHLU16UHII1PUG110HN11L11ONl$EIJAGFNI ❑�7f <br /> - --.- X .� lD-/3�87 <br /> vaoiect�nOA[ss --- .rrur.n� . cnreus� �. i�cvu�[�o 3 <br /> / 1 ! "1 1/L� <br /> ►LUM/IN6 � MECHANICAL <br /> 11p, T'rE OF F11[TURE OR ITEM FEE NO. T'PE OF EOUIPMENT FEE <br /> W11TER ClOSET(TOILET� A/C - �MNDLG UNITS-H P <br /> B�TMTUB NEFPIGERAiION IINITS-H P EA <br /> LAVATORY IWASH BASW� BOII.EPS--9 T 11 rM P <br /> SHOWER � GASFIREDAC UNITS -BTU <br /> KITCHEN SIN✓ S C"H FO{if,ED AIR SVSTEMS--B T U M EA <br /> OISHWASMG;\ � . .—_' "--- --' -- ' 1YAILNEATERS-"�iU M <br /> LAUNDNYTR�Y UIIIiMEAiFRS-�TU M <br /> GLOTHES WASMER EVAPORATWE GOOLENS <br /> URIN�I CLOTMES[1FYER5 <br /> pqINKING FOUNTAIN VENTII A71ON FAN <br /> FLOOR ORAIN RnNGE 11000 <br /> BACKFLOW PPEVENTERS WAT[R NF.ATER <br /> NOOf DRA�NS-PAINIEA�ERS WO00 STOVE <br /> SINK�SERVICE--B4R EiC� METAL FIFEPIACE 8 CIIIMIJEV <br /> FIR[PIACE INSEfii <br /> REAi PIIMP <br /> GAS PIPING <br /> Ea'11FI15T 1"AN <br /> S118 TOTAL { SIIB TOTAL <br /> PERMIT { "— — P[PMI� _ <br /> TOT�LFEE f TOTALFEf <br /> inorv*scio�r,e�� etaAseiu�r.� smisnoecK <br /> ' r��ANGiEGY:NUMdEP FEE NECEIPTNO <br /> usczone ior•nc. „Acuns�rt FEES VALUATION FEE <br /> uris urio — S <br /> OUILUING <br /> TVP[Of�ONSi OCCUP�4CV GROUP f�0 OF OWFII iNG UN�tS <br /> PI.UMOING <br /> S�ZC or BI oG rvo Uf StOni6 1�+r oCc �OAO MECNANICAL <br /> O1HEN <br /> f IFE SPRINKI.EHS REOUIfiED I] VES ❑ NO — gTATE BUILDING SUHCIIARGE <br /> SiATE ENERGYSUNCIIAHGE <br /> nVPI�Ct1iON<CCOv i'I�i+Sf.HCf.KCDOY APPR1001'v511�N(.C9V pUBLICWORNS <br /> � , G � TOTAL <br /> — PROPERTY OWNER��ARE RES1'ON$IBLE FOR DETERMININ6 ALL <br /> PHOPERN LINE LOCAT�ONS AND RELATEO EASEMENTS. <br />