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,�.E .,o,,,� �-,PPLiCATiON FO��+ fVe,� , <br /> ��� �� CONSTRUCTIQN O <br /> everett PERMIT <br /> BUILDING DEPARTMENT <br /> 259-8010 TO BE COMPLETED IN INK - PLEASE PRINT <br /> ❑ DEMOLITION �Q COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> ,�nr.�r� M+n nuout a ��rv In� r��o�u __— <br /> �l- Eort�l��--��c f914 /S• 3`I p/v� _ StRttl�. qklo3 SY�-Bzi3 <br /> a111 r�i�l l l ll��I�1'����11 II M�II TII[INl•�•� '�• . 1'1111N! <br /> 5,.-M� <br /> i�l yUul t,�q�nn, i��n N�n eUtlnl;F �.�rv ti�� nuOHF irt.i qtt . <br /> s,�ru,� 6eo�ei i���- <br /> .. nw,re� CnHvu��.n� Mu� �ODRL55 r:��v :o- .�oN[ irt'l.�y . <br /> P�uMHVp}tap�neilJe M��I �ON�FtiG i.i�� ;,p PullryF lulry'd • <br /> Pue6oT5nueJ Dla�xb�nv_ Zo2y I.J•Cits,v�o E�ccelr 98to�! a93-4s3� Pu6Fr� 14io� <br /> C��SS�.� WOax <br /> � NEW ❑ ADDI110N ❑ ALTEFATION ❑ REPAIH ❑ Df.MOLILUN ❑ WOODSTOVE/FRPI INSERT ❑ BUILDING RF.lflCallON <br /> W�w,.�wo� Nt�a..<nse.n eurtWNl.rYu•,1�11N1. _ <br /> /� <br /> �'� }� rXJ <br /> i�iscF����=;,�E/J -HouE L'eA9'}1Unc11'e� ��7/�.7�1�—�-- <br /> 17 <br /> u•,i or ouu o�.�c <br /> I NERfBY CERTIFV THAT I HAVE READ AND EXAMINED TF11S AP� <br /> �ESid�acE PLICA710NAND KNOW THE SAM[iOBE TRUE ANDCORRECI AL L <br /> �i,niu�ticn�rnnaornnorrni•�ti«owr�et�owon��r�o�rouar.00�t>,� VROVISIONSOFLAWSANDORDINANCESGOVEPNINGTFIISTYPE <br /> -�'� ��pt�, OF WORK WILL BECOMPLETED WITH WHETH[RSPEGFIED HEFE <br /> i���—�ei ocs—o� IN OR NOT THE GRANTING OF A PERMI7 DOES NO' PR[SUME TO <br /> GN[ AUTHORITy TO VIOLAT[ OR CANC[L THE PqOV1510N5 OF <br /> ANV OTHER STATE OF LOCAL LAW REGULATINGCONSTRUCTION <br /> OR THE PERFOfiMANCE OF CONSTRUCTION. <br /> SGNaIUnEr)r ���)yrnnrli,ROnaUI��O�a;[Oa�.f�.� i�.��f <br /> X �� E e <br /> a...�a ,n•� ,l� _ r <br /> rao�t� ��C,•nErti •rr;u �r�n,i i n uu5��u a i., t�ni <br /> � <br /> PLUMBING MECMANICAL � <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE � <br /> f� WATER ClOSET ITOILET� � � A�C-A'MNOLG UNITS-H P I <br /> B�THTUB REFFIGERATION 11NIT5-M P EA <br /> �- UVATORY IWASH GASINI llOILERS-A T U�N� I <br /> 'J/ SHOWER ) liASfIRFOAC UNITS-9TU _ <br /> NITCHEN SINN 6 CISP �� fORCEO RIR SVSTEMS-B 7l1 M EA <br /> OISHW�SHER WnL..HEr1TEPS-B T U M <br /> LAUN�RV TR�" UNIi HEATERS-A T U M <br /> CLOTMESW�SNER :�) FVAPO�ATIVECOOLERS <br /> IIRINAL � CIOTMES nHYER$ ' <br /> �RINKINfi FOUNT4IN VENTILA71ON FAN <br /> iL00���AIN RANGE MOOD ,�.i � ) <br /> FACKFLOW PPEVENTEHS � WATER MEATER -�J <br /> h'1f1F DRRINS-fiAIYLEA0ER5 WOOD$TOVE <br /> SINK ISERVICE - P4R ETC 1 METAL�6 CNIMNEV _ _ / <br /> GIREPIACE INSERT <br /> HEATPUMP <br /> (iA5 i'IPINfi <br /> ENM�USTFAN <br /> SUO TOT11L f � Q eUB TOTAL ! � (�(� <br /> PERMIT 1 PERMIT <br /> TOT�L FEE f � '- 'd� TOTAI FEE S�� ) .1 <br /> ,�,� i:•;r�ue . --- - i�1•��..!�aa eiOE tif�N.cr — •K�N CnE;K Nl1MBER FEE RECEIPT NO <br /> ��^ ' � � �� �'� �� � ��� �t^�1�� <br /> - G `�; � � <br /> —'� 'd°�• v�c�rns�rc FEES VAWATION FEE <br /> .(�' � � 0�],7 Jrf.511No <br /> � �o � o�-cun.r�crcaoun rio orowFu�r�,uHux BUi�DiHG 3 i '� jp�.l ���J : U' 1 <br /> � � � ti . 3 r P��Ma��� , , �. <br /> •.:! �..1,p ��� HO Of 910RIE9 M�� pCC IOAD <br /> �� �t '� Y•),.r,.' _� AAFCHANICAL l 'I U <br /> Ui11ER <br /> PIRt SPRINNLERS REQUIFED ❑ YES ❑ NO 9TnTE 9UILDING SUNCHARGE :� j � <br /> STAfEENE�G�SURCHARGE �� <br /> .�—� .- . tlr t4�N5CNE[xF�er er��n ionc;sun����p. —� <br /> PUFiLIG WORH$ <br /> �- <br /> ��� �i� ; � rorn� , , - - <br /> � � . <br /> ---�' . _ - `---- _i <br /> PII0PER7V OWNEFS ARE RESPONSIBLE FOR DETERMINING ALL <br /> PROPEFfY UNE LOCATIONS AND RFLATED F./.SFMENTS <br />