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i ' <br /> �T� � r <br /> �P.PPLICATION FO�.-,' ���,�„ <br /> '".E"'°'"" CONSTRUCTlON �, <br /> cm or <br /> '` everett PE RM I'� <br /> BUILDING �EPARTMENT <br /> 259-8810 TO BE CCIMPLETcD IN INK- PLEASE PRINT <br /> ❑ DEMOLITiON ❑ COMBINATION O BUILDING ❑ MECHANICAL Q PLUMBING ❑ SIGN <br />�li� OWNER M11411 AflURE55 CI�Y ,., )IP PNONE <br />,�; � (��� �Yl/l I�-�l �('l�(Q_ ��� �����7-�rZC� <br />� ARCNIiECIOROF51pNl-O MAR�O[lljkS^. fRv .iP 191pNf <br />�" 'T��k�\I� � ��+_1���1 �f'l�._���11�2�1;� -�I. '_ �1��J��-��, <br />�� GtNER�LCONIRRCIOR � 1.'� �1111lIF55 ��� �� �'��ObF ��CENSE• <br /> �1�C��A.A�.�-L�) l `}'� ' � '• ���o� <br /> i ' `�dECN�N�GLCONIHnCiDq Mn�II�PBEFS i:ir liP / PunuF IIGF.NSF • <br />, ` ����� n� <br />� -- <br /> - PWMBIY�iCONtRnC10N AIAq nDPOESc 1'.I�i JIP 1`IiUrF IIC�EHSE� <br /> � CU• OF WORK <br /> 1 .. �NEW ❑ AODITION ❑ ALTERA710N C� REPAIR ❑ OEMOLI110N ❑ WOOOS70VE/FRFl.INSERi ❑ BUILDING RELOCA710N <br /> y <br />�, • V�LU�TIONOfWORv,�CC519��A�ERiqt$PLUSLnNO�� <br /> (�� <br /> D �BE OnK • <br /> `�t ��-e - <br /> �� � USEOFBu1LOING <br /> �I� �'. ' I f�iEREBY CER�IFV Th{qT I HAVE READ AND EXAMINED THIS AP• <br /> � � I/`�J��l � fulG. pLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL <br /> � ieaF�oesca�cn r+orPRJPERtYI$IIOWNBElOW0�A1tAGRFO11rlf,U[�IFS PROVISIONPOFLAWSANDORDINANCESGOVERN�NGTHISTYPE <br /> �•"� OF WORK WILL BE COMPLETED WITH WHETHERSPECIFIEO HERE <br />'�'" IN OR NOT.THE GRANTING OF A PEf?MITDOES NOT PRESUME TO <br /> . io�—e�oc�—or_ <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> � !' ^ ANYOTHERSiATEORLOCALLAWREGULATINGCONSTRUCTION <br />� �� OR THE PERFORMANCE OF CONSTRUCTION. . <br />. . � sic�+niuneorc: �nnn' onon unwn� c Nr nAre <br /> /, <br /> X /C32&S� <br /> I'� PHOJECinDDRE55 Af'f'lif.Aul'tiC�Ivf3i.anE55 if,4n5EN0 <br /> !D8 !9 � � . S.�^ , <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET�701LET) A/C-A�HNDLG UNII"5-MP. � <br /> ' BATFITUB REFRIGERATIONUNITS-H.P.EA. <br /> . UVNTORV IWASH BASIN� BOILEflS-B.T.U.lH P. <br /> SHOWER GASFIREDA.C.UA' "S-BT.U. <br /> KITCMEN SINN 8 DISP. FORCED AIR SYSTI^5-B.T.U. M EA. <br /> DISMWIISHER WALLHEA7Ei75-O.T.U. M _ <br /> LAUN�RV TRAY UNIT NEATERS-0.T U. M <br /> i <br /> CLOTHES WASNER EVAPORATIVE COOIERS �_ <br /> URINAL ��OTHESORYERS <br /> ORINKING FOUNTAIN VENTILAT�ON F/�N <br /> fLOOR OAAIN RANGE HOOD <br /> BACKFLO R RS WAT R E <br /> R O D AI -RAINLEADERS WO OVE <br /> SI K ICE-DAR.ETC� ME'�AL FIf1EPl�CE 8 CNIM EY <br /> FIREPLACEINSERT <br /> HEAT PUTAP <br /> � GAS PIPING _ <br /> � � EXHAUSTFAN <br /> SUB TOTAL f SUBTOTAL ^ <br /> PERMIT f PERMIT II <br /> TOTALFEE S TQTALFEE <br /> PLnN Cri CN Nl1MBE�1 FEE RECC �.0. il <br /> INONi$EIOAf.n REARSEIBAGN SIOESEIOACK C� ����� � �� �� �_ �� I <br /> USE IONE �or nnen vncnr�i snE FEES VALUATON FEE i <br /> ❑YES CNO �y�,,� <br /> BUILDINa S/�,t.�� �5�� � �i <br /> fYPEO�CUNSf OCCUPANryGf.OUP NOOFOWFLUNGl1NIiS � <br /> � � � � �- 2 `d" PLUMBING ' I <br /> SIZE Of BIDG NO O(SIO�IES MA% OCf. IOAD MECMANICAL I <br /> 358$ l 3S �� <br /> OTHER <br /> FIRE SPRINKl.ERS REOUIRED LI YES y{NO _ .__ STA�E 9UIL�IN(:511(iC11AfiGF. I II <br /> � <br /> STATEENERG�SUrCHARGE i <br /> AI'PIICRiION�CCqv PIAHSCIIECNFU�Y AfTlifOf1155UANCEOY p��BLICVlORKS <br /> � r� C� ' � ' T07AL ', <br /> PROPER7YOWNERSARGRESPONSIBIEFORDETERMININGALL I <br /> PROPERTv LiNE LOCATIONS AN�RELATED EASEMENTS. I <br />