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IAPfw•prwn AePLICATION FOR <br /> Dim of CONSTRUCTION <br /> everett PERMIT Ei <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK - PLEASE PRINT <br /> ❑ DEMOLITION ❑COMBINATION ry BUILDING n MECHANICAL 1.7 PLUMBING ❑SIGN <br /> nWNIR MMI.fN)R[89 CITY AI pNO•'I <br /> 8B:9C��S�risT�Nc. ��371 NE L�t►T C� #8t212 Reanond"I-w', ri�62 ffi5-39C1� <br /> Buunu uNm sa:NRl uAn mogtas rn rno�N. <br /> 1 NLR,I CUNIR.LIDn MEI,ADDRESS CIry !IP npNl I ICLNSF r <br /> �N CoNsr, TNN Same GS :R R 5084 13L <br /> MLC,I,NCM CIIIIII,CIOR MAN ADDRLS9 CIM1 !d PupNl lILt1151 <br /> PLUMBING CONTRACTOR MMI ADDRESS CITY tn' NONE IKIN91• <br /> 1 ESS Or WpRA <br /> NEW ❑ ADDITION ❑ ALTERATION ❑ F I, R ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION <br /> wl ua'oN nr wnpF)yRfMue a u <br /> RueoRl <br /> Of CRIBE Wn • f-��-.._ 1 - <br /> usr or BRu Rmc <br /> la 0 11+IQ I I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> IPLICATIONAND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> mu olsr.RlPuoll nr Pnnrlgrvl NnwNenow nNATucrITtNIRum'rs, PROVISIONSOF LAWSAND ORDINANCES GOVERNING THIS TYPE <br /> la,_-Lelo<a_m #� OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE- <br /> IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GRE AUTHOR.I Y TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> A' • OT,IER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> ON-HE PERFORMANCE OF CONSTRUCTION. <br /> -- SIJN4111RE Of CONDUCTOROR AUTHORIZED AGENT DAIL <br /> X <br /> PROJECTADDRI SS URICANT9 LIIY SHFINESS IKENSE NO <br /> 3'55- (d7tr S+ SE Evere4 lkla. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET ITOILET, I <br /> A,G -A•HNOLG UNITS-HP <br /> BATHTUB REFRIGERATION UNITS-H P EA <br /> LAVATORY WASH BASINI BON ERS-S T U M P <br /> SHOWER GAS FIREDAC UNITS-BTU <br /> KITCHEN SINN{DISP FORCED AIR SYSTEMS-B T U M EA <br /> DISHWASHER WALL HEATERS-BTU M <br /> LAUNDRY TRAY UNIT HEATERS-BTU M <br /> CLOTHES WASHER EVAPORATIVE COOKERS <br /> URINAL CLOTHES DRYERS <br /> DRINKING FOUNTAIN VENTILATION FAN <br /> FLOOR DRAIN RANGE HODO <br /> RACXFLOW PREVENTERS WATERHEATER <br /> 'BOF DRAINS-RA114LEADERS WOOD STI'VE <br /> SINK(SERVICE-BAR.ETC I METAL FIREPLACE B CHIMNEY <br /> RR[PLACE INSERT <br /> NEAT PUMP <br /> OAS RPINO <br /> EXHAUSTFAN <br /> SUB TOTAL S SUBTOTAL i <br /> PERMIT 1 PERMIT 1 <br /> TOTALFEE E TOTALFEE E <br /> InuNi sE reifx - NEAR SEMACn SIDESETB.CR RANCH CK NUMBER FEE RECEIPT NO. <br /> USE F LOT AREA VACANT SIE <br /> 1 o / FEES VALUATION FEE <br /> b 5�% iQ rT. .Y-a ONO <br /> IYPEO�Dygl OCCUP1NCY=RRK3UP Iq OF pRTIIINO UNlr9 BUILDING 5 <br /> -"•TC-j'N R 37 PLUMBING <br /> SUE OF BI DR NO OF STORIES MMI OCC LOAD <br /> Sazl,5F / A14 MECHANICAL <br /> GAO • .-A:s+P% OTHER <br /> FIRE SPRINKLERS REQUIRED O YES NO STATE BUILDING SURCHARGE <br /> STATE ENERGY SURCHARGE <br /> APP,ILAIIDM•LL BY RANSCNECKEp1Y APPA FOR OW.NCE BY <br /> /)! � e PUBLIC WORKS <br /> 4 2 <br /> /�AC <br /> •`�/(A./1L// r /ASL TOTAL <br /> PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING ALL <br /> PROPERTY LINE LOCATIONS AND RELATED EASEMENTS <br />