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,�.E..,,�.� APPLICATION F'OR <br /> �.r o. ��e <br /> everett CONSTRUCTION <br /> BUILDING DEPARTMENT P E RM I T <br /> 259-8810 TO BE COMPLETED IN INK - PLEASE PRINT <br /> ❑ DEMOUTION ❑ COMBINATION L?'SUILDI�'G ❑ MECHANICAL ❑ PLUM8ING <br /> ❑SIGN <br /> ()WNIF. 411 /.11IIli� �. ( IV <br /> :v P�rt1N1 <br /> '�/C �r 17 I"� 1'"A /�� ��f 1--7 -j LYJ �w� . �✓�'�'{i 77 A.�7a'c/ S;{� `�`7 <br /> �Rf.Nrt[(IUPDIbpNFN M�n �pON!$5 <br /> ., v .e 1�6�N1 <br /> liFNtN� C:]NiO�lipp Mbt +f�1�1115ti �i� )Nf <br /> ���c �7-W� �-�w2,nH.�. , �.J�� - � �. ' .� ,��:�,�s�. <br /> — �1-,io. �-rr �Tr�,! <br /> , � <br /> MIfM�N�f�l G7NINIC!(�R M1111�1OP[�S f.�•♦ /il' <br /> r��nNf uCfM51 • <br /> owMPM':CONI1Ut1Un M�q�ODFF55 ��i�� ��, <br /> PnONF ILL.IN11 • <br /> Cl1$501 WOf1e.�{ . <br /> � NEW �C7 ADOITION ❑ ALTERATION ❑ PEPAIR ❑ DEMOLITION ❑ WOOOSTJVE/fRP�JNSERT ❑ BWLDING RELOCAiION <br /> \�1111ti1]N�11 W()Rn.f.(1.'�Iill AI�IINI�L V`LU9l1PnR� <br /> � ���• ��a �9 9 !��� - <br /> lll SlPitlt W OHn - <br /> ''�{� Cv � T O {1cri,v ,� <br /> usf uv Bw�n�r.r <br /> X I FREBV CERTIFY THAT I HAVE READ AND EXAMINED Tf115 Ap� <br /> '�F�7bC�� PLICATIONAND KNOW THE SAME TOBE TRUE ANOCORRECT ALL <br /> ir,�io[5r,nivnnworvnovcarv,sNowr�e[�awon��r.o�rounr.nmrs� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPE <br /> io�_e�ocn�_or OF WORI(WILL BE COMPLETED WITH WHETHEF SPECIFIED HERE� <br /> IN OR NOT TNE GRANTING O�A PERMIT DOES NO7 PRESUME TO <br /> GIVE AUTNORITV 70 VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANV OTHER STATE OR LOCAL LAV✓qEGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTf7UCTION <br /> seN��un���.�tononnun�nq�eroaarar na�� <br /> X � � ✓ � � <br /> caoicc*�ooacss ' <br /> .�,.,.,.�� ,�-,.,,,,�.��,., � r 3 <br /> x r�tir •�n <br /> �� � /�O �i,v . .FvlRSlf. Si`�E' "'`✓ <br /> PLUMOINd MECHANICAL <br /> NO. TYP!OF FIIITURE OR ITEM fEE NO. TYPE OF EOUIPMENT FE! <br /> W�iEN CLOSET�TOILET� q�C -rI�HNDLG UNITS-M P <br /> B�TN7U8 qEFqiOEARiION UNITS-H P EA <br /> V�.VATOPV IWASH BASM� AORERS-B T U�H F <br /> $HpWEN GASFIqEDnC UNITS-BTU <br /> � 1cITCHEN S�NN 6 DISP FOACEO�iH Sv5TEM5-B T U M EA <br /> CISi1W�SMEF WA��HEAiEPS-8 T ll M <br /> LAVNDRVTR�V — <br /> UN1i MFnTERS -B�U M <br /> CLOTHESWn$MER EVAPOFPTIVE COOIERS <br /> UNINAL CLOI'HES OFYEPS <br /> ORINNING FOUNTrIIN VENiILAiION FAN <br /> F�OpR�R�IN PANGE HOOD <br /> BACKFLOW PREVENTEfiS WA7ER ME�TEP <br /> ROOF DR�W 5 -R4 WLEAOERS WOOD STOVE <br /> SINN ISERVICE -B�R.ETC� METAL FIREFLACE 6 CMIMNEV <br /> FIREP�ACEINSERT <br /> MEAT PUMP <br /> GAS PIPING <br /> EMHAUSTF�N <br /> sue ror�� i <br /> aue ror�� <br /> KRMIT � <br /> PCRMIt <br /> T0TI1L f[! f 70T�L F[f <br /> �i�uNr sE rg��y eF�n tit tB��.e SrtIE S��B ce KpN CNE R NUMBER FEE PECEIPi NO <br /> / -S C p � /� <br /> i0 ,q n��Aa.,.ti �� r� c��� � C� �'��-- ` L i ���� <br /> Jtif[UNf 101 IPH <br /> S �.c�r�rs�n FEES VALUATION FEE <br /> .Eti o <br /> ����� n���� OCCUP�NCV GPOIIP NO O(pWFLL�NOUNItS eU1LOING � <br /> ✓ '� � - � $ PLUMBINO <br /> S�lf J� H�p�� NO Of StOFiE9 M�� OLL LO�O <br /> r(D S f / /'/� MECMANICAL <br /> 1 <br /> OJMER-• �IpN� <br /> FIqE SPRINHLERS REOl11RED ❑YES NO � <br /> STATE BUIIDING SURCHARGE � <br /> ST�TE ENERGYSURCHAPGE <br /> ���°�° a ' �4 a'�. flv �R�NS(HECaEOBY �PCR (OR19611�N�t B. <br /> PUBLIC WORKS <br /> � /� <br /> �� TOTAI <br /> PROPERTV OWNERSARE RESPONSIBLE FOR DEIERMINING FLL <br /> PROPERTV L WE LOCATIONS AND PEL4TED EASEMENTS <br />