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'ti:PPLICATION FO:�� ���,�„ , <br /> `�""'°'"° CONSTRUCTION <br /> C11'I OF <br /> everett PE RM IT <br /> BUILDING DEPARTMENT <br /> 259�8745 TO BE COMPLETED 'Y INK- PLEASE PRINT <br /> ❑ DEMOLITION O COMBINATION ❑ BUILDING ❑ MECHANICAL I�,PLUMBING ❑ SI6N <br /> OWN[9 MMl�OP11 53 CIiV iP ' p110NE <br /> '�(�',��un. � `:�.-_�'r.�►.�r 1 �rv�l���nn i ���7<,� c,���+,<_� iu� (�Zi,ii�ir_►�1�� ���a�0 �,���-'�l3'� <br /> ♦ Hil LI RpESiO��ER MAIL�OORE53 LIIY 21P l PIION[ " <br /> G ryEN4CONiR�L10N MAIL AO�RE55 ,Clry 21P PNOHE 4CENSE• <br /> ���r��nvrl � ( in,�l�l:�.n� %�q,.��� �,�I�'��'1 nl�. l'177_�u;�E�r , ic�E �i��)6 1�-�;���l,�c� <br /> MCCIUw�el LON�R�CtOq MAIL�OORE55 G�IfY ZIP PIIONE LICENSE• <br /> PWM9111000NIR�CfON MMLADORESS CiIY ZIP PI�ONE LKENS[• <br /> CU5501 WOfiN / <br /> ❑ NEW ❑ AODITION � ALTER�TION ��pEPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPI,INSERT ❑ BUILDING RELOCATION <br /> W LU�iION Of WORM iC091 O!M�I[NeLS PW 9 L�BOO� <br /> orscn�eewonK _ ilUSil\��. i[CY) �'LC(.y� `a11�- <br /> �� — - - �+1 .-. - _ ! 1 1' • <br /> L � pU�l01Np , - <br /> � � ` I HEREBY CERTIFY THAT 1 HAVE READ AND E%AMINED THIS AP- <br /> 1 h Ur l PLICATION AND KNOW THE SAMEtOBE TRUEANDCORRECT.ALl <br /> ieaa:oesrairuor+orrnoven�ris�wwr�oEtowonetteer�rountories� � PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPE <br /> � <br /> OF WORK WILL BE COMPLETED WITH WHETHEfl SPECIFIEO HERE• <br /> ioi_o�ocK_or IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />. GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CON5TRUCTION <br /> OR THE PERFORt�1ANCE OF CONSTRUCTION. <br /> SIONRTUREOFCON7RACTORORPUfNORIZEDAGENT DATE <br /> �/ / �CG�1 � / � '7 <br /> PHO�EGf11DU�E55 APPUC �SCItYBU51N[SSLiCEN5EN0. <br /> � ��f7�;0��! Vl l <br /> PLUMBIN6 MFCHANICAL <br /> NO. TYPE OF FI%TUIIE FEE NO. TYPE OF EOUIPMENT fEE <br /> WATEP CLOSET(TOILEI) AIR CONO.UNITS—NP.EA. <br /> �a11/TUU REFRIGEAAIION UNITS—H.P.EA. <br /> LAVATORV�WASN BASIN� UOILERS—H.R EA. <br /> SHOWER GAS FIRED 0.C.UNIfS—TONNAGE EA <br /> HI7CIIEN SINKB DISP. FORCED AIR SVS7EMS—B.T.U. M EA. <br /> DISHWASNER WALIHEATERS—B.T.U. M <br /> LAUNUpV iRAV UNIT HEATERS—B.T.U. M <br /> CIOINES WASHER EVAPONATIVE COOLERS <br /> WAIER HEATER CLOTHEODRVERS <br /> URWAL VENTILATION FAN <br /> ORINKING FOUNTAIN RANGE I/DOD <br /> FLODR DPRIN G � AIR HANOLING UNIT— C.EM. <br /> VACUUM BPEAKERS STOVE <br /> ROOF DRAIIJS—f7AltlLEADERS METAL FIREPLACE 8 CHIMNEV <br /> SIt+NISE(iVICE-9AR,EtQ "� � WOO�SiOV&FIilEPLACEINSERT <br /> SUB TOTAL .J �1 SUB TOT�L t <br /> CERMIT f � — PENMIT f <br /> TOTAL FEE f — T0TI1L FEE f <br /> THIS PORTION TO BE COh1PLETED BY BUILDING DEP7. PERSONNEL <br /> ��OYi5E�0�CN RlAq5l�0AGN S�pESE1BRGe FL�NCHEGNNUMO[tl PUNCUCCKFEE <br /> FEE RECEIATNO. <br /> USEIONE lOfAflfA ypCANT511[ — <br /> pYES ONO FEES ���UATION �EE <br /> TYVEOfCONSt OCCUFANGYGROUP NOAFOWIIIIHOlIN115 <br /> ouuc:;,o s <br /> sizc or otoo Ho or sionies MR%.00Q 104D <br /> PLUMOINO D/'� <br /> MECHANICAL <br /> FIRE SPRINKLERS i7E0UIRE0 O VES D NO — <br /> OTHER <br /> PEN�LTY <br /> APPII�AfIONFLCOY PLANSf,I1ECNE0BY RPPRFORISSWNCEBY — <br /> TOT�L �7� / <br /> ��I;� <br />