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fMEwryrwn APPLICATION FOR � <br /> CONSTRUCTION '""'" <br /> C�ry Ji <br /> everett PERMIT e <br /> BUILDING DEPARTMEMT <br /> 259-BB10 TO BE COMPLETED IN INK• PLEASE PRINT <br /> ❑ DEMOLITI7N �7 COMBINATION CJ BUILDING 'l MECHANICAL f.] PLUMBING ❑ SIGN <br /> nMni n eun .nnu�•�r, ��..r .�r• _'—_ _��� <br /> `TNF�eo.cc �t' Kw.vv.e�✓ �"�7 iCc ��ST S N. <br /> EV4RCTi YBao 3�3 - � 33' 3 <br /> ���. r��l[I��IIMI'It�ilNl�� 4�� �!'Ullttiti - ♦ lII� 1�11(INI <br /> �k�ll IrA. `�Ili<i 1 ��. _ �Ilil .\n�INL.�S ('�\ /II 1��I)NI <br /> �_. /� <br /> �� 111:lNSt � <br /> �J <br /> .q,.�a�r� .. . �..yni> . �n ���i q�nnr,� _ <br /> f.ih lio PqOryE - <br /> IICENSf• <br /> iuMHn��� yn�4� � u. .�n �DI'�q'I'v t�1V hC �uONf uCFIC:I . <br /> 1.1�)4(�1 W(1H� <br /> ❑ NEW ❑ ADDITIOP, ❑ ALTERAiION ❑ HEPAIR ❑ DEMOUTION ❑ WOODSTOVE/FRP�JNSERT ❑ BUI�DING REIOCAf10N <br /> ..i w�����v or wr,n..i o,��n r.�>rtnu�ti rius uenre '- - __ <br /> i <br /> ✓ � � 7J <br /> p1YCRiU! WJRM � <br /> ✓ $vr� � ca,e� o.cT Fo.e Mu.3� i.t r/owrL <br /> u�� ureui�nn�3 — --__ <br /> -- CA�CPOt T I HER[BY CLRTIFV 7HAT I HAVE FEAD AND EXAMINED THIS AP� <br /> PUCA710NANDKNOW THE SAME TOBE THUE ANDCORRECT AL L <br /> ununrsrnrono�un� aaoi�tn*r,snowr�e[inwon��uu�rnunu �rs, pROVISIONSOFLAWSANDORDINANCESGOVEPNINGTHISTVPF. <br /> �� �� fli���_ ����� �' t� OF WORK WILL BE COMPLETED WITH WHETHEF SPECIFIED HER6 <br /> IN OR NOT �HE GRANiING UF A PERMIT DOES NOT PR[SUME TO <br /> GIVE AUTHORITV TO VIULATE OR CANCEL THE PROVISIONS OF <br /> ANV OTHER SiATE OR LOGAL LAW REGULATING CONSTRUCTION <br /> OR THE PEFiFORMANCE OF CONSTqUCTION <br /> s�Vaa�un� n� ioqrnnr.�iatnnnun�nn�n�nn-.��ai �.n•� <br /> �u�,-,<...� ,� /r/.,:� z/Y I ? � <br /> VPO�FCI�UI�RF55 ��'P�iC�N�hU�rBUSiNlStiiiil�Hlr — - <br /> / !�� �/ U �J� <br /> PLUMBINO MECHANICAL <br /> NC TYPE Of FIllTURE OR�TEM FEE NO. TYPE OF EOUIPMENT FEE <br /> W�TER CLOSET�iCtLE�� 4�f, -q�HNOIG UNIiS-M P <br /> BATMTUB (iEFR1.FPqTIONUNI7S-HP EA <br /> UVATORV IWI.SH BASINI BOILERS-0 T U-M P <br /> SHpWER .nSFIREUAC UNITS-BTU <br /> NI7�MEN SINK 6 OISP Fpnt'EO 4IR SYSTEMS-B T U M EA <br /> UISHW�SHER W4�,LNEATERS -flTU M <br /> IAUNpRY iRAY UNIi HEATE�S-B T U M <br /> CLOTHES W�SNER [VqPOPRiIVE COOLF.RS <br /> UHINAL CI.piHFS OFVFRS <br /> DRINRING FJUNTAIN VENTILATION FAN <br /> iLOOA OAAIN fiRNUE NOOD <br /> B�CKF�OW PAEVENTERS W�TEA NEATFR <br /> ROOF OA�INS-R�INLE�OERS WOOD STOVE <br /> SINK ISERIiCE -BAR.ETC� METAL FIREP�,Af.E 6 CMIMNEV <br /> FIREPLACEINSERi <br /> HEAT PUMP <br /> 6A5 PiPINfs <br /> ENHAUSTFAN <br /> bU!TOTIIL f SUO TOT�L <br /> PFRMIT f P[RM�T <br /> T011L Fff f �OTAL FL[ <br /> '�•� a�st rpL. � af�u tit�N�� S�nE S[iB�cn �'f�A,„CNIECM NUMBER FEE NECEIP�NO <br /> ��� � � � .. YI)II`�� ' � C � \ ��1� ` I �a��1/ <br /> c � - <br /> ��� ;���E 1°r�At� vec�Nrsuc FEES VALUATION FEE <br /> �.�,� S4/�C: I;rES �O <br /> �. � tln451 ���UnIrICv(p0u� NOUiOWfLUHGUNi!ti BUILUING $ <br /> �� ' ^/ ���I � PWMBING <br /> �.:! �P tl�DU NO Ul9tqR�tS M�� OCC LOeD <br /> j� Sf � .�/A MFCHANICAI <br /> OTHER <br /> f IRF SPqINhLEHS REOUIRED ❑ VES O STAiE BUILDINC SURCHARGE <br /> STA7EENPRGYSURCHARGE <br /> a'.'..' i Ir. ���NSY��ECnEDAr �P��R i00195U�N[f Nv -� <br /> h, PUBUC WOqKS <br /> '�a� /.:.� /.r/ —' -- — <br /> TOTAL <br /> PRnPFRiv UWNfRS ARF RFSPONSIPI F FOR DFTf:RMIN�NG ALl <br /> PnIlPFR1Y LIN[ LCI(:�71ON$r1N�RFI AiFP F.ASE�dF.NTS <br />