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r <br /> ��.E�,o�.� APPLICATION F(, R <br /> ""°` CONSTRUCTB�N <br /> everett `°e <br /> PERMIT <br /> BUILDIN(i DEPT. TO BE COMPLETED IN BLqCK INK— p�EASE PRINT <br /> 259•8745 <br /> ❑ COMBINATION � BUILDINO G MECHANICAL ❑ PLUMBINO <br /> OWNER ❑ SI(3N <br /> 'j M��l�OURESS <br /> ��C9.'1.' L�o/�G .. � 3 n "J cirv :in <br /> -�_�I�i � 7 ITII/+ /S IV �y� PMONE <br /> ^ ONOCSQNfR M���OORE55 � ��" ' fN�'�/ti�') ( / <br /> GfY ZiP � Sa� O�bO <br /> OEHkRdLLOMP1C10R PNONE �`� <br /> MAIL AOORFSS <br /> 7G✓C/1 L y._l L ✓ /,IC�1 / ✓f � LiIY/ ZiP PnONE <br /> MECN�NIC.1L CONip�CtOA t� �/t J�j� �(}C�L�� n' ���ENSE• <br /> M�Il�00R[55 CitY � t�� ��_��y S�J�y �7 <br /> GNON! LI[EN E• <br /> PW MBINO CONiNeCiOR <br /> MUL 1DONkSS <br /> Clty 21P PHONE <br /> C1�53 Oi WOPR LIGENSE� <br /> ❑ NEW ��qD01T10N ❑ ALTERATION ❑ REPAIR <br /> N� � � � � M �� �i ' ' ❑ DEMOLIiION ❑ WOnn�rn <br /> cRT ❑ BUILDINO RELOCATION <br /> �ESCRIBE WONN �'�eOr"" - <br /> �� '�,o, � / �- � �� <br /> use or emimr�o �'lC cc rj � ,� , �'C��c (�rG <br /> I HEREBY CERTIFV THAT I HAVE READ ANO E%AMINED THIS Ap- <br /> IFG�LOESCqiP110NOfPqOpFPfY19110WNBELOWpq�fTACNFOUBegriesi P���AT�ONANDKNOWTHESAMETOBETRUEA�lDCORRECT.ALL <br /> PROVISIONSOF LpWSqND ORDINANCES GOVEFNIN6 iHISTYPE <br /> �orZe�octi_.�F �u!/�a U:i ���,.� OF WORK WILL BE COMPLETED WITH WHETHEpSPECIFIED HERE• <br /> �,n IN OR NOT.THE GRANIING OFA pEHMIT DOES NOi PpESUME TO <br /> "/G�n� � q r. � � ��6 GIVE AUTHORITY 10 VIULATE Jq Cq;10EL THE PpOVISIONS OF <br /> ANY OTIIEq STATF OR LO�q��;,yy qEp ULATING CONSTRUCTION <br /> OR iHE PERFORMANGE OF CONSTRUC110N. <br /> �� � �� 4 916N�fUREOFCONTR��7pqJHAU)HORKEDAGENT '`' <br /> . D�TE �-�S /�` <br /> x � � -. <br /> oqOJECT�00RE99 J L . <br /> , y / �PFIIC�NI'BCIIYBIItliNES NSENO <br /> � /✓C^S�/� /V!'l �� <br /> rLUM�INO <br /> i NO. 7_ypE O�fINTU-- ---�- MECHANICAI <br /> � WATEq ClOSET�TOILEp RFE _N0. TYP�Of[OUDYENT - <br /> ' BATNTIIB �_ AIqCOND UNITS-M.P EA —�- �E� <br /> ' LAVATORY�WASN BASIN AEFRIOERATION UNITS-H p.EA. <br /> _ SI/OWER BOILERS-MP EA <br />. NIiCMEN$IqK s DISP. -r-- QA9 FIRE[A C UNITS-TpNNAOE EA -- <br /> DISMWASNEN _ FOqCEO AIR SY9TEM9-0 T U M EA. - <br /> LAUNOqYTq�y WA��HEATERS-Bi. � . <br /> CLOiNES WFBHER UNIiHEATERS-BTU. M <br /> WATER HEATER EVAPORATIyE COOLEHS - <br /> UNINAL CIOTHES ORVERS <br /> DRINNINO FOUNTAIN �ENTILAII�_pry p�N�_ <br /> � FLOOq DP•�N AANOE NOOD _ <br /> _ VACUUMBqEANER9 ��RMANDtINOUNIT- CFM. <br /> ROOFDFAINS-RAINLEADERS STOVE <br /> SINK SERVICE-BAq,ETC. METRL FIqEPIACE 8 CNIMNEY <br /> ---_. _ WOOD9TOVE/FIqEVLACE INSERT <br /> . '------�__ <br /> �U�tOTAL . — <br /> IEIIMR�- � —� — tU�TOTAL � --'- — <br /> -� TOTAL fEE � �IIMIT � - <br /> iOT11L f[[ � <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> iRONlgE1B��N pk�qbE18�LR <br /> �✓ � SiOE 6CTBdCN PL�N GH N NUMBEP <br /> AI7�G ��-�1 ___ ,� � PI�NCMEC6fEE <br /> , USE LONE 1 Ot�qEA � �� iEE/� =� qECE1Vf NO <br /> _/ V.1C�H1 SRF �.� / <br /> ❑YLY�NO /[[{ f <br /> LYYf O ON51 �����*��M F[! <br /> OCCUP�NCYGIIOUP NUOfUWCiLiN0UN11S <br /> BiIE OF OL00�� NO Of Sippi 5 / BUILDIHO -_ � <br /> �� / M�R �C.LO�O f <br /> PLI/MBIN6 — <br /> FIRE SPRINKLERS pEOUIR[0 ❑ YES NO MECM�NICAL -- <br /> Of11ER - <br /> ���IiC�TIOH��� gy p��N9CHELKEOBY PEN�ITY <br /> ePPN fOR ISSu�NCE BY � <br /> J�� ,o..� <br />