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i _ <br /> �I '.� �i,�; � <br /> �,;:'PLICATION FOR.�,' ���,�„ 'i�' <br /> ,".E".,°,"" CONSTRUCTION '��i <br /> �,r o� <br /> everett PERMIT . �`` <br /> ;, ;,� <br /> BUILDING DEPARTMENT ; '' "„� '�` <br /> 269•8810 TO BE COMPLETED IN INK• PLEASE PAINT � I' , + . ';. <br /> ❑ DEM�LITION ❑ COMBINATION /u BUILDING O MECHANICAL ❑ PLUMBING ;� O SIGN " <br /> �W�q M�ILAD011E55 ��TY EIP P110NE � <br /> o(j_¢rf /�'�/v-S .`1�345� � S !:�/eS'� L^�/s+L-0rt,U.S g�°2' 77�' 67Z�; ' ' <br /> ANGNIilf.lOPUkSIpNER MML�DOHE55 CITY 21P PNOltE . . <br /> ��AAM'� <br /> OlNEH�L GONIR�LIOR M�II�ODRESS C��Y IIP vupNE 4CENSE� � <br /> Sa,,,r -�aos�kQ�232N3 <br /> MECN�NiC�I.COMNIGtO� M�il�DDRE55 C fY 21P �IONE LICENSE <br /> VLUMBIN�LONIR�GIO� M�II�D��ESS CItY ZiP ���ONE UCENSE• <br /> CL�45Of WORN �,( <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ DEMOIiTION ❑ WOODSTOVE/FRPL.�NSERT ICJ BUILDING RELOCATION <br /> v�tuevor�o�wonKieo9ro�rnnteautsi��u5�eno � I�r,/�CQ. I , / _ �i-� <br /> ���� �7�o/O `� �i y`V�� <br /> OESCR�BE M�ONK /" � /� �� / <br /> �j ew o c�,•-r cda r/z >-� � �'�P/ c a'I�P lJc,./GI�.r q� .P/ /�rf�r�cti <br /> VSE Oi BUILUiNO I HEFEBY CERTIFY THAT I FIAVE READ AND EXAMINED THIS AP• <br /> �p, PLICATION AND KNOW THE SAME TO BE TfiUE AND CORRECT.ALL <br /> LEO�l0E5CPiPl10NO�PpOPEHfYiS��OWNOELOWOf1AttACNFOUPCOPiE51 pROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPE <br /> OF WORK WILlBECOMPLETED WITH WHETHER SPECIFIED 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 /> C K _ ANYOTHERSTATEORLOCAILAWREGULATINGCONSTRUCfION <br /> / OR THE PERFORMANCE OF CONSTRUCTION. � <br /> _�_�C7'- �p(!� 6/dCL� SJY' 910NA7UREOFLONiFACiOHORRUTMOR�ZEOAGENT bATE �� <br /> X �z7 -�� <br /> �PPLIGANTSCIIYBUSINESSLI NSEtiO � <br /> PROJEGt�pDHE55 � � <br /> PLUMBING MECHANICAL � <br /> Np, TYPE OF FIXTURE OR ITEM FEE NO. TVPE OF E'OUIPMENT FEE � � <br /> W�TERCLOSET�TOIIET� � A/C—NMN�L6UNIT5 �—NP. <br /> BATHTUB PEFFIGERATION UNITS,—HP.EA. <br /> �AVATORY�W�SHBASIN� � BOILERS—B:T.U.MP <br /> SHO�NER GAS FIRED A.C.UNIi'i—B.T.U. � <br /> KITCMEN SINK!DISP FOHCED AIR SYSTEiAS—8.1.U. M F�� <br /> � WALLHEATERS—B.T.U. M <br /> O�SHWASHEP . <br /> LAUNORVTRAV <br /> UNIT 11EATERS—B.T.U. M <br /> CLOTHESWASHER -- EVAPOF7ATIVECOOLERS <br /> � CLOTMESDRYERS <br /> UA�NAL <br /> DRINKIN6 FOUNTAIN VENTILATION FAN <br /> FLOOR DRAIN <br /> RANGEMOOD <br /> BACKFLOW PREVENTERS � WATEA HEATEH <br /> ROOF OPA�NS—RAINLEA�EPS WOOD STOVE <br /> SINK(SEA�ICE—BAR.ETC.) METAI FIREPLACE 8 CMIMNEY <br /> FIREFIACE INSERT <br /> MEATPUMP <br /> OAS PIPINO � ' <br /> EXHAUSTFAN f���i'�� <br /> SUBiOTAL <br /> SUB TOTAL S � .,ii <br /> PERMIT 3 PENMIT <br /> TOTALFEE S � TOTALFEE ' ' <br /> pIAN CHE K NUMBER FEE � AECEIPT NO. I� ,j I ' <br /> �N0�+1$EIBeLk �UA SEIRAGN SIOE SE70�CR R �f II,"�� <br /> ' Z� Z.o 5 " �655 0�01 �O `�a R�l�f3.; ��� <br /> I15E tUN� ior enee YALUATION FEE � ���� �� �i'�'' <br /> veceru sne FEES � <br /> �� ES ONO BUILDING 5 � <br /> tYPF Of CONST OCCUP�HGV G110UP NO�OF 0�lllNb UNIIS . : <br /> . �/L� � 3 PLUMB�NG � '�i <br /> 512E U�e1.D0 N9 D�SIORIES Mnx occ �oeo MECHANICAL � ' ��� '�, II <br /> � e�Za^�fj, Z N� � , , <br /> OTHER <br /> FIRE SPFINKLERS REOl11RED ❑ YES�HO S7ATE 8 ILDING SURCHAR E � '� <br /> i <br /> $TAT[ENERGYSUACHARGE ' � <br /> �PFIIC<IIONRGCBY PI�i15CIlECNEDBY APi`f1i0l1155U�NCEOY PUBLICWORHS � <br /> �,^� � � TOTAL , <br /> V'�` <br /> PROPEFNOWNERSARERESPONSIPI.EFORDETERMIN!N A L. !� � <br /> PROPEF7Y LINE LOCATIONS AN�PELAIED EASEMENiS ' , „ , <br /> I <br /> . .. ._ -. <br /> TeSL•.'3:�b',?':�%!ii .{i+.'7 �}._ . ._. �� . . � . . . . : �'i� . . . .. � <br /> i <br />