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APPI.ICw�IOH FOR CONSTRI��:T10N <br /> PERMIT <br /> Ih�Ewrprsan <br /> CITV OF rvr�rlt <br /> everett e <br /> BUILDINO DEPApTMENT <br /> 269-BBto TO BE COMPLETED IN INK— PLEASE PRINT <br /> NEP M111 AOOf1E6B Ci1Y ZIP MIONE <br /> Cti z�.; �.-.� y i"?%id �s r °�a. �����(t—c���;_`iF�'S� C i/-yi�7 <br /> TEN1V/�� MML�DDOE95 CIIY SIP %IONW <br /> UICNItECfORpEB1ONEB NM1�0011F8! Ci�Y IiP MIONF <br /> OENFMICONIR�t10R / Mql�00f1f5� CIIV )IP � PIqNE IIGEN6Fi <br /> �J.S�lJ �1:J.f,lF�r) /YC47)C� <br /> M[CN CONIR�CTOp IMII�DDBESI GIIY ?IP %IONE IICENBE� <br /> nwwHawatw�cton MAIL�OORE!! CIIV 11P PNONE��.�����lr��ItENL <br /> �c�t�� C'.:�A�.� �/�;. {FG�3;I• 7>'—� i�.. �c.'. C'Cl�iirx.t�.: %f[�ll.' 775�7.37J � <br /> a�seorwonR ' — <br /> ❑ NEW ❑ AODITION ❑ ALiERAT10N ❑ REVAIR ❑ OEMOLIfION ❑ W0009TOVE/Fllf'LIN9ERT ❑ BUILDINO(7EtOCAT10N <br /> 1lNMIT IMVIqVEMENT ON MfERlpl REMOOEI ONLY fANGC1 PEIISON�ND PNONF NO <br /> ca�rrucr mia or wonK <br /> OElC111�!WOPM IWO 90UME fOO1ME INVOLVED <br /> Moro! OueEoieunowa IHEREBVCERi1FVTHATIHAVEREADANDEXAMINEDTHI9APPLICATIONAND <br /> ��'G �llNb� �l✓7'�� •�' KNOWTHESAMEtOBETRUEANDCORRECT.ALLPROVI&ON80FLNNBAND <br /> L[ ot wiqNor T'�lNOWNlEIOWOR n�cNrouncori[s� OROINANCE940VERNINO7HI97VPEOFWORNWILIBECOMPLEtEOWITH <br /> WHEIHER SPECIFIEO HEfiEIN OR NOT.TIiEORANTIN00FAPERMITDOEB NOT <br /> PPE9UME TO�IVE AUTHORITV TOVIOLATE OR CANCEL THE PROVI810N80F <br /> Loi e�ocK Ov ANVOTHEPSTATEORLOCALLAWREOULATINOCON3TRUCTIONOi1THEt�EH� <br /> FORMANCE OF CONSiqUCTION.Tk{AT I AM�UTHORI2E0 BY ME OWNER OF <br /> 11119 PqOPEH7V TO PEi1FORM iHE WORN FOR WNICH APPLICA710N IS MADE <br /> --- AND I COMPLV WITH iHE STATE CONTRACTORS LNN 18.27 i1CW AND <br /> 788.200 WAG <br /> lION1TUOEOFCONiMCf0110P^UINORIiEDAOENi D�tE <br /> X �✓�(��-_ �� j <br /> naxcr�oo�uee �-c.�l-. t- �-- `/ '� � <br /> •PVlIC11NTlCIIYlU9111 LICEN9ENO.ANDBUlINE!lNAME <br /> Q I �c �.�2+�. <br /> R{MA�!NO MECNANICAL <br /> N0. T►N Of RINTUII!OII IT[M F[! NO. TYPE OF EOUI�AA[NT Rlf. <br /> WATER CL08ET(TOILE7) A/C—A/HNDLO UNITB—H.P. <br /> -�- <br /> lIRNiUB FOqCED AIR 9Y9TEM3—&T.U. M EA <br /> UVATORY�VYABHBA8IM "' UNITHEAiER9—IiT.U. M <br /> BNOWEH — CLOTHEBDfiYEHS <br /> NITCHEN BINN 6 DIBP. VENTILATION FAN <br /> 018MWA9HER � � RANOE NOOD <br /> LAUNDRYTqAV WATEp HEATER <br /> CLOtNE9 WA9MER WOOD BTOVE <br /> UHINAL METAL FIREPLACE 8 CHIMNEV <br /> � DRINKINOFOUNTAIN FIpEPLACEIN ERT <br /> FLOOR DMIN HEAT PUMP <br /> BACNFLOW PREVENTERS �A9 PIPINO <br /> FOOF ORAINB—MINLEADERS E%HAU3T FAN <br /> BINN(9ERVICE—BAR,EiC.) <br /> SUB TOTAL ! Z� ^^ SU9 TOTAL f �— <br /> PEFMIT S PERMIT = — <br /> TOTAIFEE S � ` iOTALFEE S <br /> TlET6�GK �UP8E1&K'1c BIDE8E18ACN P{ANCNlCKMUM![11 I[[ IIlCBAMO. <br /> ueeioNe �mu�ew wc�wisne FEEB VALUATION fE[ <br /> ❑YE9 ❑NO <br /> fYPEOfCONlT. OCGUW�NCYOROIIP NOOfDWELLI1qUNli9 BUILDINO _ <br /> AILOMNNbl�C1U�L — — <br /> PLUMBIN� � <br /> M2E Oi BIDQ Np Of BfORIE9 B9ML OGG IOAD �� <br /> o r MECHANICAL �S� <br /> pN - <br /> NEIONILIMIIQI4M OTHER <br /> i1RE8P111NklER3HEWIPED orE! ❑r+o STATEBU�LDINaSURLHAROE <br /> STATE ENEROYSURCHAqQE <br /> MpLIG1IlONACGBV VUN9�PPRBY <br /> PUBLIC WORKS <br /> TOTAL � f <br />