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�����PPLICATION FO.{ ���,�„ <br /> ""E".°"'" CONSTRUCTION e I <br /> an ov <br /> everett PERMIT <br /> BUILDItJG OEPARTMEIJT <br /> 259•8745 TO BE COMPLETED IN I��K• PLEASE PRINT ( <br /> ❑ DEMOLITION ❑ COMBINATION O BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SiGN <br /> �W,�(Y�/U/lv l� / `/i�C/VC�pE59 � J7� I�Icb'����':.7'1 /- LGIL`�l MON[ ' y <br /> � y 9bzc i S-S-,��:�S <br /> 41CNRECIOBDEGIGNfR M�IL• ESS CITY � 210 PnONC <br /> GENCPqGONIH�CiOR M�IL�DOBG55 Cltt 21P PIIONC �IL(NSf • <br /> � �,d/'„liY�/� �. v�E/d✓C�i'1 :,1337_ ��D�?i�'�/i��i �'f�'C/�E?� �57�'/ � SS-,;��•� 1� i <br /> MLCIInNIULGONl11�CT0A M� �ODRESS �1Y 21P �NONE I�CCNSC• <br /> PLUMBINsCONiR�{�IOA M�I�AD�RESS CIiY 21P PIIOHE LILCNSC• <br /> �GL� SOf WORN <br /> NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERi ❑ BUILDING RELOCA710N <br /> VeWef�ON Of WOBe ICOSf Of M�1CRiµ5 PWS L�BORI <br /> " 'I �� Sl`� <br /> ocscniee wonK <br /> /7;cDdG��Z m�f��C /��7�. <br /> vsr or eunoi�c I HERE�Y CEFTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> �' :J %O s['��tS BFF��E pLICATIONANDKNOWTHESAMETOBETRUEAN�CORRECT.AII <br /> 1EG40ESLRiPVON'O^fPROf'ERIYISNOWNBELOWORAIT�CNfOURCOPIE91 pROVISION50FLAWSANDORDINANCESGOVERNINGTHISiYPE <br /> ioia�ewc�v j/f OFWOFKWILLBECOMPLETEDWITHWHETHEFlSPECIFIEDHEFiE <br /> IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO V�OLATE OR CANCEL THE PFUVISIONS OF <br /> �' y�i 1 ,; � � ANYOTHEASTATEORLOCALLAWREGULATINGCONSTRUCTION <br /> —� — OR THE PERFORMAN E OF CONSTRUCTION. <br /> SIGNAT 'Olit i OR i110R1ZC0AGCNI UntE <br /> X '11 % > /C <br /> PPpJEGI�pOPE53 AI'PI7C�1'SGITYBUSINESSLI lNSENO <br /> / 7� �0 ����1 / . <br /> PLUMB�NO MECHANIC�L <br /> NO. TYPE OF FIRTURE FEE NO. TYPE OF EOUIPMENT FEE <br /> WIITER CLOSET�TOILE7) AIR COND. UNITS—HP.EA. <br /> B�THTUB FEFRIGERATfON UNITS—H.P.EA. <br /> LAVATORY(W�SH BASIN� BOIL[RS—HP.EA. <br /> 5110WER OAS RREO AC. UNITS—TONNAGE EA <br /> HIiCHEN SINK 6 DISP. FOfiCEO AIR SV57EMS—B.T.U. M Ep. <br /> DISHWASHEH I WALL HEATEf75—B.T,U. M <br /> L�UNORV iRAV � UNIT HEATERS—B.T.U. M <br /> CLOTNES WASMER � EVAPORA7IVE COOLEFIS <br /> WATFR NEIITER � CLOTHES DFYERS <br /> U71NAL VENTILATION PAN <br /> OR�NKING�OUNTAIN RANGE HOOD <br /> fLOOR DRRIN AIR HANDLING UNIT— QF.M. <br /> VRCUUM BREANERS S70VE <br /> ROOF DR�INS—RAINLEADERS METAL F�REFLACE 6 CHIMNLY <br /> SINK�SERVICE—BAR.E7G \YOODSTOVE/FlREPLAGG INSERT <br /> SU"TOTAL SUB T0TI1L f <br /> PE�::.11i t PERMIT f <br /> :.`ALfEE � TOTRLFEE f <br /> THIS f'ORIION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> i�ONt SE19�CN PE�H SEiB��N 81D''6EIB�CN � PUN CNECB NUMBER PUN LN[CN fEE <br /> FEE �ECEIPf NO <br /> USE 20NE LO(�PG --- <br /> V�G�NISIiE � FEE9 V�W�TION !EE <br /> ❑YES ONO ---- <br /> Iv1`EOtCON51 OCCUP�NGYGROUP NO.OFUWElLINOUNIiS <br /> BW�DINO f7�p�j�' (D S� <br /> SRE Of B/0O NO Of SiORIES M�%OCC.10�0 — <br /> 1'LUMBINO <br /> MECNANI�AL <br /> FI{7E SPRINKLERS F[OUIRED ❑VES ❑ NO <br /> OTHER <br /> PENRLTY <br /> el•PUCAIION�Cf, BY PL�NSCi1ECNEDBY �APR.fORI55U�NCEBY -- <br /> TOTIIL IDS � <br /> L . G L - �- • — <br />