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N.,�PLICATION f0(.-� everetl <br /> �^.`w'°'"" CONSTRUCTION O. <br /> c�rr or <br /> everett PERMIT <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK- PLEASE PRINT <br /> zss•aeio <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING O MECHANICAL ❑ PLUM8ING ❑ SIGN <br /> �ISIlAOU�[55 Clrv IIP P��ONE <br /> OW . '1 <br /> � Nc�'r° �� -i/ ��"�. 2 S �-�a,�'�� c�:�-,���.T <, y���.; :�� � �/>S <br /> (�r V ea oor+csc cn n � o � <br /> C�RCHIfECTOPDt iONEN <br /> 0lNEN�I GONIR�C�O� M�II ApU�E55 C��� ZIP �PONE LICENSE• <br /> MECN�NiCµCOH1R�Ci0fl MAILe��RE55 ���� IIP PIIONE UCFNSE• <br /> PLUMB�N.CON1R�CtOR M�IL�OORE55 C�1Y bl' PnONE uCENSE� <br /> CL�SS O�WOAK <br /> ❑ NEW �AODITION ❑ ALTEPATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT BUILDING RELOCATION <br /> �iwr�nir.os��icnu�4��u.«n?�4� �� 7UV /�fjC <br /> Y <br /> oescn�ee woaK <br /> i . J(� � C� ,,�, �^..C' > - <br /> USE Of�U40MG I HER[BY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS AP• <br /> ��+� ��( PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL <br /> LEO�LOESCPIPTIONO�PAO�EIilY15��OWNBELOWOR�1fAG11f0URCOPiE51 pROVI510N50FLAWSANDORDINANCESGOVERNINGTHISTYPF <br /> OF WORK WILL BECOMPLETED WITH WHETHERSPECIFIED HERE• <br /> io�—e�oc�oF IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. . <br /> $IGNRIU OfCONffiACTORORAUfNORI EUAC,ENi OATE <br /> � � � ' c - <br /> X /1 '� ' t A .. � _ <br /> PROJELT�ODRE55 MC . i5tlrv&15 SSLICE�ISE O <br /> / <br /> S > ,.� � �G`/c' �1 G'�— �"�'� � � <br /> PLUMBING MECHANICAL <br /> NO. TYP!OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT <br /> FEE <br /> W�TEF ClOSET ITOILET� A/C—A/MNOLG UNITS—H P. <br /> REFHIGEPAiION UNITS—NP.FA. <br /> B�TMTUB <br /> UVATORY(WASM BASIN� BOILERS—B.T U./M P <br /> GAS fIRED A C.UNITS—87.U. <br /> SMOWER <br /> 1(ITCMEN SINK 6 OISG. FORCEO AIR SYSTEMS—B T U. M�� <br /> WAILHEAiERS—BT.U. M <br /> DISMWASMER M <br /> UNIT NEATERS—O.TL. <br /> LAUNDRYTRAY <br /> CIOTHES WASHER EVA70RATIVE COOLEPS <br /> CLOTHES DRVERS <br /> URINAI <br /> VENTILATION FAN <br /> UPINNING FOUNTAIN qqNGE HOOD <br /> FLOOR ORAIN <br /> B�CKFLON�PAEVENTERS W�TER HEATER <br /> ROOF DRAINS—PAINLE/DERS WOOD STOVE <br /> SIKK�SERVICE—BA0.ETC� METAL FIREPLACE d CHIMNEY <br /> FIREPLACE INSEi7T <br /> HEATPUMP <br /> CPS PIPING <br /> EXHAUSTFAN <br /> Slls TOTAL f SUB TOTA� <br /> PENMIT f PfNMIT <br /> TOTAI FEE f TOT�I FEE <br /> PLnNGME NUMBEH FEE b RECEIPTIyO��� <br /> �AONi5E10�LK � NE�RSEI9�CH SIpE5E1BACN , � �� �1�,1�C� � f/� � �� <br /> �� 2 S� 7 z �—��� �i <br /> use zoHe �oi"n�" 1 wcsr+r sne FEES VALUATION fEE <br /> �- 5 ; 600 �/� °YESJ�"'° BUILDING s i� o I� a �d <br /> rvneorr,aist occurervcvenour r+oorowruiNeur+its <br /> I �� M �/ �- PLUMBING <br /> J <br /> SKE 0�BLDa HO JF SiONES M�x OGC lOaO ��ECHANICAL <br /> �,3 Sf � �'" ni.,4 <br /> /vUO OTHEF�II}°��� — �IIp � . <br /> Fli`E SPRINKLERS REOUIFED ❑�ES NO STATE BUILDING SURCNAF7GE <br /> STATEENEPG�SURCHARGE <br /> eVPL�C�IiON�LCA Br nUHSC1�ECnEOor �PPB 1'OPi55WNCEBv pUBLICWORHS <br /> �fy �✓L /�{ TOTAL <br /> Oe V 4 <br /> PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING ALL <br /> PROPERTY LINE LOCATIONS AND RELATED EASEMENTS. <br /> ••.R.':I <br />