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, .PP �.IC�TiON FO�. e��,�„ <br /> �°.E",""" C�NSTRUCl'iON O <br /> ��n o. <br /> everett PERMIT <br /> BUILDIN6 �EPARTMENT TC BE COMPLETED IN INK• PLEASE PRINT <br /> 259•8810 <br /> ❑ DEMOLITION ❑ COMAtNATION ❑ BUILDiNG ❑ MECHANiCAL ❑ PLUMBING ❑ SIGN <br /> OWNEP MAIL100RE55 Gllv ZIP P110NE <br /> '` r_ >1i n � t- 98ad ��s�-- 3ss� <br /> q.� J /)�✓le a�au�ti i L 'le�,/ '"] � J '— -/ 7 c n z v or�c <br /> ��iiCHIfEL10R0E5� IER MAILADORE55 <br /> CEnERALCO111P�G�OP MeIL�00RE5S C��Y ]IP P��ONE uGENSE • <br /> ��[f.111NIf.�ICONII1ICtOq M�ILAOORE99 GIiY 21P FIIONE UC[N5� • <br /> �/LU�ABiNO CONiRALtOR <br /> M�IL�OpPE99 CIIV IIP PM�NE liClNSf. <br /> LLASS Of WO�Y. <br /> ❑ NEW ❑ ADDITION ❑ �LT[RATION ❑ REPAIR ❑ DEMOLITION ❑ WOO�STOVF/FRPL.INSERT ❑ BUILDWG RELOCAIION_ <br /> WLWIIOIIOF WO�Mif.03�Q! I.MR�UlSPLUSI�HORI <br /> IIFSCRIBE WORN <br /> 1 � .t: <br /> use or ow�oum I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEU THIS AP� <br /> ���,,, . ��_� �.�� PLICATIONANDKNOWTHESAMET��BETRUEAFIDCORRECT.�LL <br /> '°`�`''-"�` PROVISIONS OF LAWSAND ORDINnNCESGOVERNING THIS iVPE <br /> iccnioes RIO110�����AOPERI11^�IOW��OELOWOAAIIACNFOUFCOPIE51 <br /> � OF WORK WILL BE COMPLETED WITH WHETHER SPEGIFIED HERE� <br /> io�---ewc�—ov IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIOMS OF <br /> ANV 07HER STATF OR LOCAL lAW REGULATING CONS7RUCTfON <br /> OR THE PERFORMANCE OF CONSiRUCTION. <br /> SIGNlTU7E Of CONiRAQOR OR RUIHOAl2E0 AGENT f:<iE <br /> X,� _ 1�.,.,��,✓ � � - 13 -s& _ <br /> PROJEGTAOORE55 G'G API'LIC�Ni5C11 BUSINESSLICENSENO <br /> �C.— <br /> ' �{-�.� — W y,�l .L� � ��-�zr �• <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTl1HE OA ITEM FEE NO. T'PE OF EOUIPMENT FEE <br /> WATEA CLOSET QOILET� A/C—A/HNOIG UNITS—M.P <br /> REFRIGERATION UNITS—Ii.P.EA. <br /> B <br /> ATHTUB <br /> LAVATORY(WASH BASINI 601LER5—B.T.0/H P. <br /> SHOWEii GAS FIRED A.C.UNITS—B.T.U. <br /> NITCHEN SINN 8 DISP FOFCEU AIl1 SYSTEMS—B.T.U. M EA <br /> OISHWASHER WALLHEAIERS—BT.U. M _ <br /> LAUN�RYT{iAY UIJITNEdTERS—B.TL. M __ <br /> CLOTHES WASi�ER EVAPORATIVE COOLERS <br /> I�HINAL <br /> CLOTHESORYERS <br /> Of11NNING FOUNTAIN VENTILATION FAN <br /> RpNGEHOOD <br /> FLOO�����N <br /> BACNFL0IN PRE�ENTE�S WATER HEATER <br /> ROOF DR�INS—A���IIE��ERS WOOD STOVE <br /> SINN�SERVICE—BAR.ETC� METAL FIREPLACE d CHINNEY <br /> FIREPUICEINSERT <br /> NEAT FUMP <br /> GAS PIPING . <br /> E%HAUSiFAN <br /> SUBTOTAL S SUBTOTAL <br /> PERMIT f PENMIT <br /> TOTALFEE S TOTAIFEE <br /> ��Ip��I5E10�f,v 11[nlISE�O<CN SIOBSETOACH <br /> ' PI.AN CMECN NUMBER FEE I AECEIPT NO <br /> use m�+e �or nnE♦ vncarir srte FEES VALUATION FEE <br /> ❑VES ONO 5 <br /> BUIL�ING <br /> ���EOiCOHST OCCU�PNCYGiiO�'� NO.OFDWFIIINGUNIiS <br /> PLUMBING <br /> 54E O�BIpG HU O�SrORIES Mn% OCG LOnO MECHANICAL <br /> OTHER <br /> FIRE SPqINKLERS REOUIRED ❑ VES ❑ NO STATE BUILD�NG SURCHARGE <br /> STATEENEHGYSUFCHAFGE <br /> >PV�i(;.qON<Cf, B� fLR1i5l1�ECNEDBY FPOq FOP�SSUAFLEBY PUBLICWORKS <br /> TOTAL <br /> PROPERTY OWNERS ARE RESPONSIBLE FOR DETERM11INING ALL <br /> PROPERTY UNE LOCF.TIONS AND RELATED EASEMEN7S. <br />