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,,PPLICATION FO1. <br />�n�E�+rym� CONSTRUCTION <br />cin or <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259•8810 TO BE COMPLETED IN INK • PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ 11AECHANICAL <br />uui .nniass cirv zu• <br />own�a ' ' ' _r! :j C�:Z <br />-� ! � , ,. � ,�, .� �� n <br />�in / e n �=1 �� (' ( �� l �1 .�{ �! : ,�) �. V �/(.(�'(. <br />o1unnil�dnF51GNCR M�11 AI)OflES� CIiY ZIP <br />❑ PLUMBING ❑ SIGN <br />w�nr+c <br />jJ ."I ' J.. 5 �� j_. <br />�ENCP�L COI11R�L10R IAcI a���C55 Ci1Y 21P .•��ONF uctrvat • <br />JL�..�, i <br />rILC14N�C51 LOMp1L10H IA111 �nnniss CIIY IIP PIIONC UCCNSC • I <br />/`U � ',I;1L�)r' _ I <br />t'IUMBiN.LONfR�LiOR I.IIp �DPRL�S-- f]IV IiP PI�ON! IIf.U�SE • I <br />Cl �550� WOPN ,L, <br />❑ NEW ❑ ADDITION ❑ ALfEFATIOIJ ❑ HLPAI{7 ❑ DEh101.I11GN IJ. WOODS70VEiFRPLINSERT ❑ dWLO1NG FELOGA710N <br />v.i u�uor� or wnna ,cost oi u.*i eiu s ri us � aanra <br />`nrscA�et wnnn � • — <br />. :1)..��.. �1 . �.i . i f�i <br />•.c.,•.�_ 1�l�.�C.i_. :�,),1. �r. ,�S :��i�. c. .r��. !�(Q.Y.NI�Y"1Kdi _.. <br />+� � _; (-"/� <br />i rn�i oescairrirn <br />�O��tlIALK <br />r•cn r <br />PROJECTADOAE55 <br />� ��a� 1 ���ir�- <br />PLUMBING <br />W�TER Cl OSET �TOII.ET� <br />V BAT1iTU0 <br />y- LAVATORV IWA51/ BaSINI <br />SHOWER <br />/ KITGNENSINN60�SP <br />y LAUNDFV THAV <br />G LLOTMES �dASH <br />URINAL <br />ROOt UHnino — nn�n�c...ic <br />SINK �SERVICE — BAfi. ETL � <br />IBONi5Ei8�Ck <br />u5t IONE <br />IYPLOI CObSi <br />64f OI' 01 �G <br />sue ror.� <br />PERMIT <br />TOTALFEE <br />PEaA SEIO�CN <br />�oe� VAL�Il151�[ <br />❑Yl5 ONO <br />�vcr.niu� u001'OWfI <br />�!O Of <br />FIFE SPRINNlERS FEOUIRED ❑ VES ❑ h0 <br />IAFH <br />FEE <br />��i ieauo�� ccr, o. r��r+se�aenm ev lerva ron isswrvcE ev <br />� <br />I IIEH[BY CENTIFY iHAT 1 NAVE READ AND EXAMINED THIS AR <br />_ PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL <br />PROVISIONS OF LAWSAND OflDINANCES GOVERNING THISTYPE <br />OF WORK WILL BE COMPLETED WITH WIIETHER SPECIFIED HERE• <br />IN OF NOT. iHE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THF. PROVISIONS OF <br />ANY OTHER STA7E OR LOCAL LAW REGULATWU CONSTRUCTION <br />— OR II1E PEHFOFMANCE OF CONSTRUCTION. <br />5�4�l41UR6UI GUtIIBACIGHONAUi110RIZ[UAGENI 1�4tk <br />i/ <br />x _ L �� '-�_..c, � �'.�!� <br />APP� IGN�S CIiY OU5111 55 UCl NSE HO <br />MECNANICAL <br />NO. TVPI: OF EOUIPMENT <br />AiC -�d�NUl6UN1T5—I/P <br />NEFRIGERATIONUNITS—HP EA <br />BOIlEflS—BTUd�P <br />fiASFIRED�C UNITS—BTI/ <br />FORCED AiR SVSTEMS — B T U M EA. <br />WALLMEATEPS—01U M <br />UNITMEATER$—BTU M <br />EVAPOPATIVE COOLERS <br />CLOTHESDRYERS <br />VENTIIATION FAN <br />R�NGEHOO� <br />WOODSTOVE <br />METAL FIFEPUCE 8 CHIMNEV <br />FlNEPUCE INSERT <br />MEATPUMP <br />GA$ PIPING <br />ExNnUSTPAN <br />SUB TOTl1l <br />�— � TOTAL FEE i <br />VLnN �HECN NUMBER I FEE I RECEIPT NO. <br />FEES ' <br />aui�n,r+c 5 <br />PIUMBING <br />MECHANICAL <br />OTI/ER <br />STATE BUILDING SURCNARGE <br />STATEENERGYSURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />PROPERTYUNELOCAiIONSANDNRELATEDE SEMENTISINGALL <br />