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f�e Everpreen fr P P L 1�A�I O N F O h CVPretl <br /> ��ry�F CONSTRUCTIOIV � <br /> everett PE �f� IT <br /> BUILDING DEPARTMENT <br /> 259•8810 TO BE COMPLETED IN INK - PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION ❑ E3UILDING ❑ MECHANICAL ❑ PLUM8ING ❑ SIGN <br /> � <br /> � owrr � � �� n+A�t no[L��LS r.�v L° ��Q ��ior�E <br /> /l2� /!f/% "� � � ' �j�l,,,-11,2�tf����r�..�;�C;.�.�, , ° -� � 3� <br /> AHCRrtEC�ONUF51�lFH � I.InilAf)UNI 1 .IIY !u• V�IUNI • <br /> v <br /> G6 IIRACIOR f.lAil��DUR[55 C��'f LIP VI�ONE UCLNSE• <br /> X �Z�l� j��%-�r.�»��� <br /> �M-GI14�Uf.4LCON�iieCipq 1Adlt [1RE55 Ci�v Z'�P P�IONF. i.ILENSL• <br /> �lU1.IpiN.CONIR/GI<1R tAAil AU�R[55 CIIY ]U' PIIONE LIlGNSE • <br /> Cl�9S O�wOen <br /> ❑ NEW ❑ ADDIiION J ALTLf7AlION � REPAIR ❑ UEPdOLITION ❑ WOODS(OVE/FRPi.INS[RT ❑ BUILDING RELOCf�iION <br /> vni un�iou or wlo/n.it:o5i�� n�nt�ni,.;.::ri.ir.:lnnn�a — — <br /> �LlS��Iln � � � <br /> / > � ��� � <br /> UFF OF OL IlD G <br /> I HEREBY CERTIFY THAi I 1-IAVE READ AND EXAMINED THIS AP� <br /> J r FLICATIONANDKNOWTHESAMETOBETRUEANDCOFRECT.ALL <br /> i[cnioescnirrio�orrr�ur[varisrowi�oe�owonniracutouncomcsi PROVISIONSOFLAWSANDORDINANCES(.OVERNINGTHISTYPE � <br /> OF WORK WILL BEC0�7PLETED WITH WHETHERSPECIFIED HERE � <br /> �.ui_o�oc�—or IN UR NOT.THE GRANTING OF A PERMIT DOES NO7 PRESUME TO � <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ' <br /> ANY CTHER STATE CR LOCAL LAW REGULA7ING CONSTRUCTION � <br /> -- OR THE PEI7FORMANCE OF CONSTRUCTION. I <br /> SIGNAIUR . �-CONI�AC1('iqO�lAUII�Ofiill`DAGEHI IM7E <br /> / <br /> ,�-1 , � <br /> "��,> �, - ,,_� ., .� , I <br /> VHDIICinuDnEss nepi_irwr. (q. �P<�uFSSiirIrlS'I qp � : <br /> � /�,� �_ � ����f� �z�r�z� � _ ,,. <br /> i <br /> PLUMBING h7ECHANICAL ' <br /> NO. TYPE OF FIXTURE OR I7EM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET�TOILET� ��C --A/HNULC U�llTS—H P <br /> pATMTU� REFRIGE�nTIONUNlfS—NP EA � <br /> LAVATOflV�WASH��SINI �OIL[RS—Fl.i U�M P I <br /> SHOWEFl GASFlREpAC UNRS—B7L. i <br /> NITCMEN SINN 8 nISP FORCE�AIl1 SYST[MS —B T U. M EA. � <br /> DISHWASHER WALLI�F9TER$—OSU. M <br /> LAUN�RV TRAY UNIT HLATEf15—O.T U M I <br /> CLOTHES WASHER EVAPORATIVE COOLERS II <br /> URINAL CLOTHES D�1'FPS <br /> ORINNING FOUNTAII! �ENTILATION FAN ' <br /> FLOOR ORnIN RANGE HOOD � <br /> BACKFLOW PREVENiERS WATER HEATER 'i <br /> ROOf ORlJNS—��INLEADERS V/OOD STOVE �i <br /> SINN�SERVICE—BnR.ETC 1 METAL FlREPLACE 8 CUVdNEY I <br /> FIREPLACE INSERT '. <br /> HEl�T PUMP . <br /> GAS�IPING I <br /> FXH�U.TfAN I <br /> Sl1B TOTAL f SUO TCTAL I <br /> PERMIT f PEBMIT , . <br /> TOTAL FEE S TOTAL FEE ' <br /> � ieurvrSElUncn�� nF,�FSE�oACK SioE;[toncrc � PLnNCHECKNUM6El1 FEE RECEIPTNO. <br /> us[mu[ ior ni�[n ���q���Si�E FEES VALUATION FEE � <br /> t1YC5 I1N0 <br /> uui�oiric 5 <br /> ���'GOFCONS' OCJUPA'ICYGROUP ��OOFOWFLLMGUMLS <br /> PWMBING <br /> SilEO18�0u HO O�StOWE; �dAx OLC LOA❑ <br /> MECHANICAL <br /> OTIIEfi <br /> FIRE SPRINKLEHS REOUIREO ❑ �E3 L] NO STATE BUIWMG Sl1FlCHARG[ <br /> STATE ENEHGV SUFiCHARGE <br /> dPPI�CLIID:l;,f 11'/ �LRIlSI:IIF.CNCDf1Y APp11 �0li155U�NChtlY <br /> PUBLIC WOPKS <br /> TOTAL <br /> PiIOPEf1TY ON'NERS ARE RFSPONSBIG fOR DETERMINIt1G:�LL <br /> FROPERiY L W E!OCA1 IUNS AIJD RELAiED 615[M1t[NTS. <br />�� <br />