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,�.E,,,,�,� `i=�'PPLICATION FO►� <br /> CONSTRUCTION "°`°" <br /> uTr oF <br /> everett PERMIT � <br /> BUILDING DEPARTMENT <br /> 259-8745 TO BE COMPLETED fN INK- PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING O MECHANICAL ❑ PLUMBING �'SIGN <br /> OWHER M�IL�D�RE55 CILY IIP PNOHE <br /> C('��1NE5 /��.�J. Nz;-if:iul- 171�: I'.�'cn.n,,:y�� r��:i:r,i� <br /> •PCNrtECTOHOE5i0NER uMLGDORESS CiTY Zi' P��ONE <br /> GENFR�I CONLR�CfON MM,ADDRE55 GITY 21P PHONE UCEN9E• <br /> T'�Cr;r�l �I.��r�.�� -i_,�c . L�'. �cx 53L�) L'�v.s4u�,;r `l.�t'�/C 7''[•.ti'•; ;; ��i,i>yN�-- ,,, <br /> MECMINIGLCONiR�GiOq MAIL�DDRESS CIiY 21P PNpNE LICENSE• <br /> PLUMBINGCONiP�G10R MMLADORE53 Gltt 21P PI1pNE L�CENSE• <br /> GLASS OF WORK <br /> I�' NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING AELOCATION <br /> V �TIONOfWORN�CO510fM�1ERIALgFLU9L�B0111 <br /> �2�)��C � <br /> DFSGNIBE WORR / <br /> _ �`l'X:: <br /> �rEC .6 .�. l� .�) - 'OL : �i SZI:ItL LLN.�I .Ud [i I���'/_•Cr ' . i".i�: ��i( Ci.: ,• <br /> USE OF BWt01NG � <br /> �„ . I HEREBY CERTIFY THAT I HAVE READ AND EXAM�NED THIS AP� <br /> ��Ch�NI � PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL <br /> IEO�LDESCPiP1iONOFFR PERiY�SMOWNOELOWORATT�GNFOUHC0VIE5� PROVISIONSOFLAWSANDORDINANCES30VERNINGTHISTYPE <br /> OF WORK WlLL BE COMPLETED WITH\YHETHER SPECIFIED HERE• <br /> ior_eiocK_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 pEGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIGNATUREOPCONTRALTOROgAUiHOPIZEDRG[NT DATE <br /> /1 <br /> i / / <br /> x CTt� �r��- ��t� C fi> <br /> PROJECi�DDRE55 �PPLIG�HTSCIIYBUSMESSUL NSEHO. ! � <br /> �v �0 )�I) <br /> PLU�181N� MECHANICAL <br /> NO. TYPE OF FI%TUflE FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET TOILEn AIF COND.UNITS-H.P.EA. <br /> BATHTUB REFRIGERATION UNITS-H.P.EA. <br /> L�VATORV(WASH BASIN) BOILEFS-N.P.EA. <br /> SMOWER GAS FIRE�AC.UNITS-TONNAGE E0. <br /> KITCHEN SINK 8 DISP. FORCED AIR SVSTEMS-B.T.U. M EA. <br /> DISHWASHER WALLHEATERS-B.T.U. M <br /> IAUNDRYTRAY UNITHEATERS-B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WA1ER NERTER CLOTHES DRVERS <br /> UFIN�L VENTILATION FAN <br /> DRINKiNG FOUNTAIN RqNGE HOOD <br /> FLOOR DRAIN pIR HANOLING UNIT- C.F.M. <br /> VACUUM BREAKERS STOVE <br /> ROOF DRAINS-RAINLEAOERS METAL FIAEPLACE 8 CIIIMNEV <br /> SINK SERVICE-BAR,ETC. WOODSTOVE/FIqEPLACE INSEtiT <br /> SUBTOTAL SUBTOTAL f <br /> PERMIT f PERMIT S <br /> TOTAL FEE 1 TOTIIL FEE f <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> iRONT5E19�CN RE�RSE78�CN SIDESETB�CK PLRNCNECKNUMOER PLRNGNECRFEE <br /> FEE RECEIPT N0. <br /> USE 20NE ��t�RE� V�GANT SITE <br /> �YES ONO FEES V�lU�T1�N FEE <br /> TYPEOfCONSi. OCCUPPNGYGPOUP NO.OFOWELLINOUNILS <br /> BUILOINQ S <br /> SIEE OF 91.OG. NO OF SIORIES MAX.00G LOAO <br /> PLUMBIN6 <br /> MECHRNICAL <br /> FIRE SPRINKIEFS REOUIRED ❑VES ❑ NO <br /> OTHER <br /> PENALTY <br /> �PPLtC�iION�CC BY PLANSCIIECNEDBY APPRFOBISSU�� - <br /> C� TOTAL <br /> � <br /> �• 3-87 <br />