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' �..PPLICATiON FO:�: ���,�„ <br />' '"'`"�'"" CONSTRUCTION 0 <br /> �,n� <br /> everett PERMIT <br /> BUILDING DEPARTMENT <br /> 25P•8810 TO BE COMPLETED iN INK- PLEASE PRINT <br /> I ❑ OEMOLITION ❑ COMBINATION O BUILDING ❑ MECHAN�CAL O PLUMBING ❑SIGN <br /> ,�µ.H�q MAIL�DDPES$ GIiV ZIO PNONE <br /> P�-rK'GRrr�v .2avic[s aC•i3�X Z.�9 lYti��l�vcY�i> >vA 9FcYl�. 'I7.�-F.c.-� <br /> �nGNIfCL�OROES�(�GNER MuIApDRC55 C�n' 2�O PMONC <br /> '\�/� <br /> �:LNER1lGONINGGtON MMI�DURC55 GIY bl' �HONE LIGENSC� <br /> Mr���'�c��' {t/1�Ir�r� l'<-�ts1 zzsi- ti�,��r-���`.A/ ,/tf•i�Ll 98io9 �Gf�,'�:-%/%I r.YnKriic•n� <br /> tAECM�NIG�,LI CONIIi�CTOq M�IL�ODRE55 Cilv 2iv CnONE LICCNwC• <br /> �n <br /> oLUMBINOCONiRALiGR MML�DDAESS GILY 211' PIIONE LIClNSE• <br /> NA <br /> CL�55 or wORK <br /> ❑ NEW ❑ ADDITION ❑ ALTERAiION �REPAIR ❑ D[MOLITIOIJ ❑ WODDS70VE/FRPL.INSEf7T ❑ BUILDING RELOCATION <br /> I�W/.)IONOf WO�K�ICOS�OFIA�TCRIALSPWSL�OORI <br /> ��J 7rJ2.87 <br /> nEs nie[w nn <br /> / � l F- M 6 - O L <br /> USEOI BI11LDiNG I HER[BY CERi1FV THAT I HAVE READ AND EXAMINED THIS AP• <br /> J - L ^ ' PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT,ALI <br /> tCWLD[SCRIPIIONO� ROPERiY15MOWNBCLOWOR�iTACNLOURGOPlES1 pROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> OF WORK WILI.BE COMPLETED'vVITH WHETHER SPECIFIED HERE� <br /> io�_e�ocK—or IN OR NOT.THE GRHNTING OF A PERMIT DOES NOT PR[SUME TO <br /> GIVE AU i HORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> EVEfrET7' DNI',-IOIJ � kFGL - -C . � ANVOTHERSTAtEORLOCALLAWREGULA7INGCONSTRUCTION <br /> OR THE P[RFORMANCE OF CONSTRUCTION. . <br /> SIGNAiUtiE OI GONiRACTOR O�AUIIIORIZ[0 AGCNi pAiE �� <br />�� /.,-r5 /I- 14 �` 6k'Rcr/r.N F Lot" I <br /> x � s �� /7 /j(/ , , I <br /> I 'J "! . 'IJI�t': � � � � <br /> I PFOJECT�OOPE55 �1 /��r 4Pf'IIf.CN!'SCIfY9115iNC55liClH5EN0 �. <br /> ��� � <br /> I �— . 'O�V' sj -1'�R� Dl8/74- <br />�� PLUMSING MECHANICAL i <br /> ryp, riPE OF FI)(TURE OR ITEM FEE NO. TYVE OF EOUIPMENT FEE � <br />� WATER CLOSET(TOILET� A/C—AiMNDLC UNITS—M.P. I <br />� B�THiUB REFNIGERATIONUNITS—IiP.EA. I <br /> UVATORY�WASM BASINI OOILERS—B.T.0/M P. I <br /> I — GASFIREDA.C.UNITS—B.T.U. ' <br /> SHOwEH <br /> IKITCNEN SINK 6 OISP. FORLED AIR SYSTEMS—B T.U. M ER. ,I <br />� DISMW�SHEfl WALIHEATEf75—BSL. M <br /> ELAUNDNY TPAY UNIT HEATERS—B.T.U. M <br />� CLOTMESW�SHER EVnPOPnTIVECOOLERS � <br /> i <br /> UR�NAI CLOTHESDRVENS <br /> ORINKING FOUNTAIN VENTIIATION FAN <br />� FIOON DR�IN PnNGE HOOD <br /> P B�CKFLOW PREVENTERS W�TER MEALEH <br />. <br /> ROOF DHAINS—RAIN�EAOERS WO00 STOI'E <br />� SINN�SERVICE—BAR.ETC) METAL FIREPW CE 6 CHIMNEV <br /> i� <br />+ FIREPU�CEINSER� _ <br /> j NEATPUMP <br />� GA$PIPING <br /> EKH�USTFAN <br />' SUE TOTAL i SU!TOTAL <br /> VERMIT t V[PMIT I <br />' TOTALFEE f TOTAIfEE I <br />� ���ONI SEiB�Cn NE�n 5E18�CK Sm[SC;OeCK "��N GHECN NUMBER FEE RECEIPT NO. <br /> �.�sczoNe �ornnee veeeHrsre FEES VAWAiION FEE � <br /> ❑YES ONO � <br /> BUILOING S � 57 �- �Q i <br /> IVPEO�CON51 OCCUP�NGYGROUP NOOFUWEILINOUNIIS <br /> PLUMBING <br /> 9ZE Of B106 NO 0�STOA�E9 MR%.OGF LO�D <br /> MECHANICAL <br /> OTHER <br /> FIRE SPRINKLERS REOUIRED ❑VES ❑NO STATE BUILDING Sl1RCHARGE �, <br /> S7ATEENERGVSUHCHARGE <br /> •�'PUCAl10N�GC0Y vl�N1C11ECREDBY PPCR.fONI55U�NLEBY <br /> PUBLIC WONKS <br /> � TOTAL <br /> �.�� � <br /> PROPERN OWNERS ARE RESPONSIBLE FOR DETERMINING ALL <br /> PROPERTV LINE LOCA710NS AND RELAYED EASEMENTS. <br /> ■ <br />