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� <br /> `•.:.�PPLICATION FO.�' ���,�„ ' <br /> ���Evvpm.a CONSTRUCTION O � <br /> crtv oF <br /> everett PERMIT <br /> BUILDING DEPARTMENT <br /> 259-8�45 TO BE COMPLETED IN INK- PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION Ld BU►LDING ❑ MECHANICAL ❑ PLUMBING ❑SIGN <br /> aH,i�Ep MAII ADOPE55 CI� 21P PIIONE <br /> ✓/7 e,�r r '� ���s e :Z3 5" l�r '�a e u�.t y �ve✓'e 7Z` �/'ao I a s-a - � 9�C- <br /> •RLMIIECIOROESIONER M�IL�DORE94 CtY 2P PIO E <br /> OENEP�LCONIR�CiOfl M1IUUOPES4 CITY 2iP PNONE I�LENSE• <br /> f G'un er <br /> iIECN�NIGLGONiP�LtOq MAl1�0011E59 G�IY 21P PIIONE LICENSE• <br /> PWMOIN6CONIR�CIOR M�ILADORE55 CITV ZIP PIIOH[ IICENSE• <br /> Gl�SSOf WOPN <br /> ❑ NEW ❑ AODIiION ❑ ALiERATION �AEPAIR ❑ DEMOLI710N ❑ WOODS70VE/FRPL.INSEqT ❑ BUILDING REIOCATION <br /> v�yueuor1 o�wo�n��!�-r�n�r nmis r�us uoani <br /> � � V <br /> OtSCRIBE WO�N <br />� � �Qe roo� <br /> �Eorew�owo I HEREBY CER7IFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> � �1V C Il+ i PLICATION AND KNOW THE SAME TO BE TRUEAND CORRECT.ALL <br /> iEa�to[scnin��onor O EPfY�9110WN8ELOWOR�1i�C11FOU11COP1E81 PROVISIONSOFLAWSANDORDINANCESGOVERNINOTHISTVPE <br /> OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED NERE• <br /> tor—e�oc�_o� IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PNESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUC710N. <br /> SIGNATUPEOFLONiRRCTORORAUTNORI2EDRGENT DRtE <br /> X �G'LO. ��f.�-Ci ct�C/ s/z � 7 <br /> PROJEp AOORE55 l �PPLIG�NI'S CIIY 6USMESS IICENSE NO. <br /> � � 35 /��� :U � Pd"`t Eve�e� <br /> PLUMBINO � MECHANICJ.L <br /> NO. TYPE OF FIKTl1RE FEE NO. TVPE OF EOUIPMENT FEE <br /> WATERCLOSET�TOIIEA AIRCOND.UNITS—N.P.EA. __ <br /> BATHTUB REFRIGERATION UNITS—H.P.EA. <br /> L4VATORY(WASH BASIN� UOILERS—H.P.EA. <br /> SHOWER OAS FIRE�AC.UNITS—TONNAGE EA _ <br /> KIiCNEN SINK 8�ISP. FORCED AIR SYSTEMS—B.T.U. M EA. _ <br /> DISHW�SNER W�LL II[ATEHS—B.T.U. M <br /> LAUNDRY 7RAV UNIT HEATcaS—B.T.U. M <br /> CLOfHES WASI/EH EVAPORATIVE COOLERS _ _ <br /> WATER HEATER CLOTHESDRYERS <br /> URINAL VENTILATION FAN <br /> �NNHING FOUNTAIN RANGE NOGD <br /> FLOOR ORAIN AIR HANOLING UNIT— CF.M. <br /> VACUUM 6REAKERS StOVE __ <br /> ROOF ORAINS—RAINLE�OERS METAL FIREPLALE 8 CHIMNEV <br /> SINK�SERVILE—BAR.EiC. WOODSiOVE/FIREPLACE INSERT <br /> SUD TOT�L SUB TOTAL f <br /> PEIiMIT S PENMIT = <br /> TOTAL FEE 1 TOTIIL FEE 3 <br /> THIS PORTION TO BE COMPLETED Bl� BUILDING DEPT. PERSONNEL <br /> fRONf5EI0nLN �iGI15C10ACR SIDESE1p�CN PLANG11iCKNUMOLII PL4NCIIELNfEE ' <br /> FEE �ECEIPI N0. <br /> USE 20NE �OI��f.� y�C�NT SIIE V�LUATION FEE <br /> �YES ONO FEE9 <br /> �' � <br /> fYPEO�CONS�- OCCUP�NCYGIIDIIP NO.OFOWELIINGUNII9 � <br /> euiioiNa s �����_` i.__ ��, (.� ` <br /> SiZE Of BIUG ��0 01 StOP1E9 MR�.OCG LOAD <br /> PlUM01NO <br /> MECHANICAI <br /> FIRE SPRINKLERS REOUIRED ❑YES ❑ NO <br /> OTIIER <br /> PENpITY <br /> �CPLICRIION>CC OV �lPN5C11EGBE00Y RPPIi.fOfiI55U�NCEBY <br /> .oT�< < � �.�l� <br />