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�PPLICATION F4,� ���,�„ <br /> ,".E",°'"" CONSTRUCTION <br /> �Itt OF I <br /> everett PERMIT e i <br /> BUILDING DEPART!AENI j <br /> 259•8745 TO BE COMPLETED IN INIC- PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNER MAILIIDORE55 Cltt ZIP VHONE <br /> �va�.. IG L��ic� c�' �lo\'ljjt��:a��uay r-u� . <br /> �RCMifEGIOR0E510NEN M�ILADDNE54 CIiY 21V PHONE <br /> GENER�LCONTF�CIOF �M�II�DORE55 CIIY 21P PNONE 4CENSE• I <br /> s� Sr� s h� .�� ��E� ;��r�a - �i;�-�ti sf s� .��;�«�� ���- ����o� <br /> MECH�NIG�LCONIPACTOfl MAIL�ODRESB C11Y ZIP P��ONE LICENSE• <br /> PLUMBIN6COMMLLOR M�ILAODRE55 CIIY ZIP PIIONE 4CENSE• <br /> L1�550iWOPN / <br /> ❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILD�NG RELOCA710N <br /> V� IONOjFWORN�COSTOFM�tENI�tS�WSLABOi11 ' <br /> 2 V O `--, <br /> DESCRiOE WONN ' <br /> U\ , • VUv� � C7.� �(�C ✓ �«�^'� 5 <br /> useor ew�oiNa � I HERE�Y CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> �ca�� F 4k�� I�'� . PLICATIONANDKNOWTHESA�dETOBETRUEANDCORRECT.ALL <br /> PuoNo�PaoPcnrr� Nvwr+oew:':^ns'.•rHrountoviea . PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> � OFWORKWILLBECOMPLETEDWITHWHETHERSPECIFIEDHERE• <br /> �o�—e�oc�_or IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> � GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROV�SIONS OF <br /> ANYOTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION� <br /> , OR THE PERFORMANCE OF CONSTRUCTION. <br /> " SI6Nr1iUNEOFCONiPACTORORAUTHOR¢EDAGENT DATE <br /> I ` � C <br /> PPOJEGf�DDRE55 I APPLIC�NTSCIiYBUS!YESSLICENS NO. <br /> PLUMBIN4 � MECtIANICAL <br /> NO. TYPE OF FI%TURE FEE 120. T'PE OF EOUIPMENT FEE <br /> WATER CLOSET TOILET) AIR COND.UNITS-H.P.EA. <br /> BATHTUB ' REFPIGERAiION UNITS-H.P.E0. _ <br /> LAVATORVIWASH BASIN� BOILEFS-H.P.EA. _ <br /> SHOWEP GAS FIREO AG UNITS-•TONNAGE EA � <br /> KITCHEN SINK 8 OISP. FORCED AIR SVSTEMS-B.T.U. M EA. <br /> DISHW�SHER � WALLHEATERS-B.T.U. M <br /> IAUNDRY TH�V UNIT MEATERS-B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLEHS <br /> WATER HEATER CLOTHES�RYERS _ <br /> URINAL VENTILATION FAN <br /> DRINKINO FOUNTAIN RANGE HOOD <br /> FLOOR DPAIN AIR MANDLING UNIT- C.F.M. <br /> VACUUM 017E�KERS STOVE _— <br /> ROOF ORFINS-RAINLEADERS METAL FIREPIACE 8 CNIMNEY _ <br /> SINKISERVICE-BAR,EiC. WOO�STOVE/FIREPLACE INSERT _ <br /> BUB TOTA 8 T TAl • __ <br /> PERMIT f PERMIT S _ <br /> TO7ALFEE i TOTALFEE � 3 _ <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> in�MSEtB�CN RE�115EIB�CK SIOES[TB�CK PUNCNEGKNIIMBEN PI�NCHECNlEE <br /> '. p� � �[ � �I fEE RECEIPT NO. — <br /> o ✓ 7 <br /> lISE 2UNE LOf pREA y���NT SI1E , <br /> FEES V�IUATION FEE <br /> OYES ONO <br /> fYPEOFGON51 OCCOV�NCYGROUP NO.OFDWELLINOUNIIS S _ <br /> BUILDINQ S � � <br /> 5¢E Of B1�0. NO,OF SIOPIES M�X OCG 10�0 <br /> PLUMBING <br /> MECNANILAL <br /> fIRE SPRINKLERS REOUIRED ❑YES O NO <br /> OTHER '7 �� � <br /> PEHPLTY _ <br /> �VPUW710NnLC 6Y PLANSCIIECNEOBV � APV0.FOf1195UANCEBY <br /> TOTAL <br /> �• I'� • S i a- <br />