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_-� _ . <br /> r.PPLICATION FOI� eVefP„ <br /> r^•FY•,flr~^ C O N S T R U C T I O N O <br /> ��r oF <br /> everett PERMIT <br /> BUILDING DEPARTMENT <br /> �n� 259-8810 TO BE COMPLETED IN INK- PLEASE PRINT <br /> L+7 <br /> p x .. ❑ DEMOLITION ❑ COMBINATION �BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> Q9 y y � ���y���� MnItPDOFi55 Citt .�� PHONE <br /> r y �=�24 ��i�.,i\ �ol�7bun-c�n�S 7.L�, ��x����i M�Ja'�f1c�i<<E9� zJc <br /> y' � H dHCNIfFCiOfil]kS�GNER MAILAO�RE55 CIiY ZIG PMONE <br /> Ki n ._� <br /> H�w ;U <br /> �Yi O GiNENAL LOfQRPCI P M1IAILj DORE55 C�•` ZIP �MONE lICE1lSE• <br /> r-i nd y <. L , , , �=� ���� f'/h2v'Svi[�t ��il �sz)o C-s�i-D�i _uer,� c <br /> �n Kr�- C,o�J s-rnwcn J c 7�, O G� s �eu�.i <br /> y yz(�� inLG�AWCaLCON1RaCiOR �ia�La0DFE55 CiiY SiP PIIONE LiCEt�SE• <br /> Q F..� � �'LUI.IBING CONiR4CIOR MTIL AOORE55 LiLY LJ' PIIONE IICENSE• <br /> H� g <br /> �w C� CLASSOFWpRa <br /> z y "� ❑ NEW ❑ �DDITION � ALTERATION ❑ REPAIR ❑ DEMOLIiION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILOING RELOCA7�01! <br /> '� C=� wwnnUNO�wunr�co5t0 bu�Lnc.L5CUi5Lne0Po <br /> ��� � �i: <br /> HH / co0 �j <br /> y <br /> H orswieEwoun � <br /> �a�' ��sJ GU LFC � f3 CJ/G1- ,Jd,9!� ?� I�/S�.uG ��OG - <br /> tjf t'� usr or uw�o�r+c I HEREBY CERTIFY THAT I HAVE READ AND EXAM1IINED THIS AP- <br /> H VJ "F- L '✓S � PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL <br /> y � � �ccuoescAianoaoraaoaearvisMowrvee�owoanrrac�vouacacies PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> � OF WORK WILL BE COMPLETED WITH WHETHERSPECIFIED HERE- <br /> io�—e�oc�_ov IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> n GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ��. <br /> � Sfr,f-' 7/fM�7C ANVOTHERSTATEORLOCA�LAWREGULATINGCONSTRUCTION � <br /> OR THE PERFORMANCE OF CONSTRUCTION. � <br /> $iGNAiURE OF CONiRAQGR 0�AUT R12ED AGENT DAiE �/�/�� � <br /> X lJ�,_ <br /> PRCJECi<pOR[55 I � ^ APVIICANitiCIiYBUSIN[SSLiCH15E��0 ', <br /> � i 4 � 9 -r�m�-n��;��ks �" - <br /> PLUMBING MECHANICAL <br /> NO. n'PE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOII.ET) AiC—AMNDIG UNITS—H P <br /> '�1 BATMTUB PEfPIGERATION UNITS—M P.EA. <br /> LAVATORY(WASH BASINI BOILER$—B.TL.�H P <br /> $HO W ER GAS FIRED A�C.UNIT$—B.T.U. <br /> 1�' KITCHEN SINN S DISP fOFCED AIR SYSTEMS—BS.U. M EA. <br /> f�1 OISMWASHER WALIHEATER$—BT.U. M <br /> LAUNDRY TRAY UNIT MEATERS—BSL M <br /> CLOTHES WASHER EVAPORATWE COOLERS <br /> '�' UFINAL CLOTHES ORYERS <br /> 1 ORINKING FOUNTAIN VENTILATION FAN � <br /> FLOOR ORAIN RANGE HOOD <br /> ' BACKFLOW PREVENTERS WATEfi HEATER , <br /> ROOF�RAINS—RAINLEAOERS WOOD STOVE <br /> � $INK�SERVICE—BFR.ETC) METAL fIREPLACE d CMIMNEV <br /> ' 1 FIPEPIACE WSERT II <br /> ' ' HEAT PUMP � <br /> � -- <br /> GAS PIPING <br /> �' — EXHAUSTFAN <br /> ' SUBTOTAL f SUBTOTAL <br /> PERMIT S PERMIT <br /> �' TOTAL FEE S TOTAL FEE <br /> �� ��+uvr SC.iBnc;�� aE<a SEienCn Sio[SEi6nCrc �LAN CM K Nl1MBER FEE �� RECEI�T NO. <br /> _I .� � ���In(c�o�j I(�— G�3�77 <br /> ._ __. use_oNE �ar anen vncar+r srtc FEES VALUATION FEE <br /> �'7.-�� �.Es;Yo <br /> � euaowc s <br /> -,v�u�co�isr occuanrvcvcnoua r+oorowr^uiu�curvrts <br /> � `CY" PLUMBING <br /> SilE OV aLOG NO Of SfORIES MAN OLC LOAO <br /> MECHANICAL <br /> ..�- �--- <br /> G��d PY �S� OTHER <br /> RRE SPRINKl.LRS RF.OUIRED ❑ Y S O STATE BUILDING SLIRCHNRGE <br /> STATEENERGYSUPCHnRGE <br /> nl"'�.'.::.LOhx:: BV PlAN56�ECNEOfiY APPP fOR19511RNCE3Y <br /> � , PUBLIC WORKS <br /> ,� � <br /> ��j �;/� TOTAL <br /> — PROPERN OWNERS ARE RESPONSIBLE FOR DETERMINING ALL <br /> PROPEFTY LINE LOCATIONS AND RELATED EASEMENTS. <br />