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�I <br /> , <br /> � APPLICAtION FOR <br /> '"'E"ro'"" CONST�UCTION everetl <br /> aTM oF � <br /> everett PERMIT <br /> BUILDING DEPARTMENT <br /> 259-8745 TO BE COM�!_ETED IN INK- oLEASE PRINT <br /> ❑ DEMOLIT'ION ❑ COMBINATION Iffi.BUILD{NG ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> ( <br /> OyWw�ER MAIL�DDPESS GITY ZIP PMONE <br /> l�ol�-��.)cQn �.;� 2y(oC� � O� S.� 4�-� l- .WA- , q�04d <br /> •RCNiTEC!OROE:IGNER M�LL�OORESS ��TM 21P P��ONE <br /> nn�a A�.��. ��-e c,4< az_�a as�-�arz.� A� . � . Se��!-(.� , c.,�A. <br /> �NEflAICON/iP�1GiOR2 MAILn�DNE55 I (� CITY ('� ZIP PHONE IIGENSE� <br /> �1 l_ Y�IU-•�Y�nQc� �°l(�''J � h� 7C� �la . Y�.:�1,2 ��1� . ��l(6g 433•(01� <br /> MECN�NICR LONiP�GTOq M�IL�OORESS CITY Z.P PMONL IICENSE• <br /> PLUMBINGCONTflAG10R MMLADDflE55 CIiY 21P PIIONE 4LENSE� <br /> CUS OF WORN <br /> . NEW ❑ ADDITION ❑ ALTEP.ATION ❑ REPAIR ❑ DEMOLITION ❑ WOOOSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION <br /> •�,U�iION OF WOflKIWSI Of MAI[1iUL5 PWS IPBOflI <br /> / A <br /> �� It 6 � ��U�•� <br /> � CNIBE WOHn ( (� 1_ 1 <br /> IwS-k-4l� J'�I.• 'L '�D ✓C .�. C.CltnO D �`�J'�'e lS1h'/JC' - <br /> U Oi6UIL0iNG <br /> �� I HEflEBY CERTIFY THAT I HAVE READ ANU EXAMINED THIS AP• <br /> �.lQ,� C�roc2-1 S'l'�V� pLICATIONANDKNOWTHESAMETOBETRUEAND;ORRECT.ALL <br /> {EG�LOESLFIPTIONOFPflOPENIY�SHOWN9ELOWORRTTACHFOUflCOPIESI PROVISION50FLAWSANDORDINANCESGOVEPNIttiGTHISTYPE <br /> r OF WURK WILL BE COMPLETED WITH Wf IETHER SPECIFIED HERE- <br /> � �or—e�ocK—ov INORNOT.THEGRANTINGOFAPERMITDOESNOTPRESUMETO <br /> 'f GIVE AUTHORITY TO VIOLATE OR CANCEL THE PFiOVISIONS OF <br /> I � vQ�� ��y� L�`�L„�����1�.�,�,., Cv.f 2tt ANY OTHER STATE OR LOCAL LAW REGULATING CONSTFiUCTION <br /> OR THE PERFORMANCE OF CONSTFUCTION. <br /> A C(.cfl�. �/'�' ( <br /> q�,p �IA'( Y'QCUVcS�CS- �✓� vr�. IZ. SIGNATUHEOFCONiRACiORORAl1THOR12EDACENT DATE <br /> �, �o � co✓e�s o 5�,��li.�n..'.skCo wk . X/ �.>'1 �� 7 � 8 6 <br /> FpOJE �O�flESS APPLICANTSCITYBU51 SSIICEN5EM0. <br /> {^ �; ` <br /> �P JeL� J\, ���. �" �l) C�IC�(�,�R...� ��.. <br /> PLUAiBING MECHANICAL _� <br /> yp, TYPE OF FI%TURE FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSETI701LEp AIR COND. UNITS—H.P.EA, <br /> BATHTUB REFRIGERATION UNITS—H.P.EA. <br /> LAVATORY�WASH BASIN� DOILERS—H.P.EA. _ <br /> SHOWEfl GAS FIRED AC.UNITS—TONNAGE EA. <br /> KRCHEN SINH 8�ISP. FORCf:O AIR SVSTEMS—B.T.U. M EA. <br /> OISMWASMER WALLHEATEflS—B.T.U. M <br /> � LAl1N�RY TRAY UNIT HEATERS—B.T.U. M <br /> CLOTMES WASHEA EVAPORATIVE COOLERS <br /> WATER MEATLR _ CLOTHES DRYERS <br /> URINAL VF.C?ILATION PAN <br /> DfiINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN Alfi HANOLING L1NIT— C.f.M. _ <br /> VACUUM BREAKERS STOVE <br /> ROOF DRAINS—RAINLEADERS METAL FIREPLACE 8 CHIMNEY <br /> SINKISERVICE—BAR.E7C. WOODSTOVE/FIREPLACE INSE(iT _ <br /> SUB TOTAL SUB TOTAL 5 <br /> PEHMI7 S PEPMIT 5 <br /> TO7ALFEE S TOTALFEE f <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> LPONTSEIBnCK AEARS.ET/OACN SIpESETBRCK `PLRNCIIECHNl1MBER PL�NCIIECNFEE <br /> " " � � � VY / 1�C� I iEE ��= FE O � _ <br /> CI <br /> USE 20NE LOt ApE� VACAN:SITE FEES VAl11ATI0N FEE <br /> �{�Z ���- , OYES p(NO <br /> Ii <br /> TYPE OF CON`ST' OCGUPAQNLY GPOIIP N0�OF DWELLINO UNITS 9/� �� �J <br /> �'/Y /,J�� BUILDING S 7lil'�� � �`�} <br /> SRE Of Ii�DG NO OF STORIES MR%.OLC.LORD <br /> /�` �L /�� / � PLl1MBING <br /> � r � <br /> MECHANICAL <br /> FIRE SPRINKLERS REOUIRED ❑ YES NO OTMER <br /> PENnLTY _ <br /> APPUGAtIONACGBY PUNSLHECNEOBY �PPfl.FORI55UANCEDY <br /> TOTAL <br /> S �lEl� � . G <br />