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,�,F�ro,�� APPLICATION fOR ���,�„ i <br /> ��ry°� CONSTRUCTION <br /> everett PERMIT e <br /> BUILDING DEPARTMENT <br /> 259•BBiO TO BE COM1:PLETED IN INK - PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINA��ION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> uw.�i.w - u�n eon�:n,a � ��� :�� nnoqr <br /> � ' <br /> / o��• ,���nn,t /H.� 7-/cw`�Lv�. J av. 5��, e�s f,�.�G,(_Ll/aa.i QrraatJ � �i7- D �- 9 <br /> � •n(IIIi1('���RU!'.iqVlu M/.R �DOHF35 ��iv :1. PHONL <br /> 'il�iYfl�l l V��1fiA�1.)1: M�il �[1[llle'iS (:'�V Ilf` VI��INE <br /> ��( �j � ,,+ {� ��Lf Ntif• <br /> «J�� 6 - �CIRl�+�^.�-� .-�.'![�r,( M1iL n..�irn� <br /> v .WW, q .v��H , inq Mu1 �OORE55 ph [IG pnpNF I�CINSf• <br /> %UMNM�III`NfF�l�i)R M111 �DONf55 � R� (iP p�IONE IH.UIlf • <br /> CI�N+I�� KOa <br /> ❑ NEW � ADDIiIOk ❑ AITERATION ❑ REPAIR ❑ DEMOLIfIGN ❑ WOODSTOVE;FPFUNSEPT ❑ BUILDING RELOCAiIOPI <br /> '.qu��n)NO� W m.{p9plM�ttAi�lGrLusl�PnR� -- <br /> �L�� � <br /> -.,,���,� ,�,>A. <br /> c����s7'. CktYL'�oizi �r�ps <br /> u,r o.p�:�i n�a„ <br /> � - I HER[BV CERTIFY THAT I HAVE FEAD AND EXAMINED THIS AP� <br /> �� PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT nLL <br /> �� ��irnsr.aicni�ao� oqi�P[pTv�SNOWNBELOWON�Ii�G�i0UPC0�rtSi PROVISIONSOFLAWSANDOFDINANCESGOVERNING7HISTVPE <br /> � ��.��,����� OF WORK WILL BECOMPLETED WITH WHETHER SPECIFIED HERE� <br /> � i � in�-K_er IN OR NOT. THE GRAIJTING OF A PERMIT DOES NOi PRESUME TO <br /> GIV[ AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS Of <br /> ANV OTViER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> - OR THE PERFORMANCE OF CONSTRUCTION. <br /> 5i0N�luAcnicn4rn<!)rGaonnUn�On�p�onctNl n<tr <br /> X a• ,(�-�-�.,.� I i ��-I �n <br /> vuo�ecr���ou[cs ,/- envnc�r�rticm u• rr�si�urwtan <br /> V�/ � L' <br /> PWMBING MECHANICAL <br /> NO. TYPE Of FII(TURE OR ITEM FEE NO. TYVE OF EOUIPMENT FEE <br /> W11TER CLOSET�TOILET� A�C -4�HNDlC UNITS-M P <br /> BATMTUB AEFRIGER�TION UNRS-H P EA <br /> LAVATORY IWnSM B�SINI BOILERS-B T U-H P <br /> SHOWER GASFIFEDAC UNITS-ATU <br /> 1(17CHF.N SINK 6�ISP FORCED AIR SYSTEMS-P T U M EA <br /> OISHWASHER WALL MEA7ER5-8 T U M <br /> LAUNORY TRqY UNIT HEATERS-B T U M <br /> CLOTHES WASHER EVAPOPATIVECOOLERS <br /> URINA� CLOTHESORYEPS <br /> ORINNING FOUNTAIN �ENTIIATION FAN <br /> FLOOFl n�plN RANGE HOOD <br /> BACK=IOW PAEVENTE�S WATER HE�TER <br /> �OOi'OFAIN$-HFWIGDERS WOOD$TOVE <br /> SINN�SERVICE -BAR.ETC 1 METAL FIREPLACE 6 CHIMNEV <br /> FIPEPLACEINSERT <br /> MEPTPUMP <br /> OAS PIPING <br /> ENMAUSTFFN <br /> !U!TOTAL f EUB TOTAL <br /> VERMIT t P[PMIT <br /> TOTAL FEE f TOT�L FEE <br /> �,.6:,�t�rn./� � i+�sn si re•�.. smc sne+r,. �'�A���E' NUMBER � FEE � I� RECEIP7 NO <br /> CJ � � �' � � <br /> ���f /ilNf Wf�PF� <br /> 1 v�c• r rc E S VALUATION PEE <br /> . _�t""l.� �� ^'! 5.:�T .:vE5�0 <br /> , ,.;yv. qrcuvur�cAvcr.our HoorowR��nGUNr*s BUILDING S <br /> � <br /> 1 �' Iv ry' �� � PLUMBING <br /> :1 ��� b�1".� qq �p 510PoE5 M�r OCC iO�p <br /> S7G 5f � N� MECHANICAL <br /> 07MER <br /> FIRF SPq�NkLERS REOUIRED L' vES S�NO S1ATE BUILDINGSURCHARGE <br /> $TATEENERGYSUACHARGE <br /> _�� . -n�iyd..' p. nl�N5C1�ECKFUPv ��PH �ORISSU.1HCk8V <br /> � � /� PUB�ICWORKS <br /> ��.(�j /.3,.f� TOTAL <br /> i _ <br /> PRUPERTV OWNEfiS ARE i7LSPOM310LE FOR DETERMINING ALL <br /> PFOPERTV LINF LOf.A710N5 AND�ELAiL�FASFMENTS <br />