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�.;PPLICATION F0►_� ���,�„ <br /> '"'E""�'" CONSTRUCTION <br /> proF e <br /> everett PERMIT <br /> BUILDING DEPARTMENT <br /> 259-87a5 TO BE COMPLETED IN INK• PLEASE PRINT <br /> ❑ DEMOLITION ❑COMBINATION ❑ BUILDING ❑ MECH:4NICAL ❑ PL.UMBING �SIGN <br /> �.qEq M�iLI10DRE54 CITY 21P VNONF <br /> IIPCHIiEG/ORD�P�� M�I���� � �,�'r�� �� �. �V�� W� PNONE <br /> GEMER4CONiN�LfOB Mq�eD�RE55 ptt 2iP PMONE LIGENSC• <br /> ���¢Y N£�/r�/ Cv �7vc l� U. �BdJc 5��9 LYNN �v�! gfrv+/G 7�N£sE3s Rc�2RYNZv7 cd, <br /> MELN�NiULGOHiR�LiOfl MML�ODRE59 C�T' Z�P PNOt+E L4ENSE• <br /> MUMB�NOCONTP�CIOH M�IL�DORESS GITY 21V PIIONE UCENSE• <br /> GL�SS Oi WOPK <br /> � NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ DEMOLITIOIJ ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION <br /> V�IU�t�ON O�'WORF�C09T Oi MAiERUL$f'W S LABONI I <br /> ���� � I <br /> OE�S A�BE WOHK '� <br /> �/11d�.Q S � k 10� 9T1jZL tJ .• � r i _ c✓ N .S�EX� �i <br /> useoreuaoi�o � I I HEREBY CERTIFY THAT I HAVE READ ANU E%PMif�EU THIS AP• <br /> r'�J�w+C7tG.t�L �S�FD �"� PLICATIONANDKNOWTHESAMETOBETRUEAND:iORRECT.ALL i <br /> LEO�LUElCRIFiIONOFPROPERIYI�MOWNBELOWOH�TT�CNFOURCOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNIN6THISTYPE �. <br /> OFWORKWIILBECOMPLETEDWITHWHETHERSPECIFIEDHERE � <br /> �or_etoc�—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 OTIIER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIQNATUPE Of CONTRACTOR OR AUTHORIZEU�GENT OAiE <br /> X zs� � <br /> PPOJEGTAODRE55 �PPLiC�Ni GItYBU5�NE55lIGEN5EN0 <br /> 2�cJy � 13�?oi?U�H'i' <br /> PLUMBINO MECNANICAL <br /> NO. tYFE OF FI%TUPE FEE NO. T'PE OF EOUIPMENT FEE <br /> WAiER CLOSEi TOILEn /�R CON�. UNITS—H.P.EA. <br /> BATHiUB REFPIGERATION UNITS—H.P.EF. <br /> UVIITORV�WASN BASIN) BOILEFS—H.P.EA. <br /> SHOWER GAS FIRED AC.UNITS—TONNAGE EA <br /> KI7CHEN SINK 8 DISP. FORGED AIR SVSTEMS—B.T.U. M EA. <br /> DISHWASHEF WALLHEATERS—B.T.U. M <br /> I�UNDRV TR.1V UNIT HEATERS—B.T.U. A1 _ <br /> CLOTHES WASHER EVAPORATIVE COOLFRS _ <br /> WATER HEATEH CLOTNES DaYERS _ <br /> URINAI VENTILATION PAN __ <br /> DfiINKING FOUNTAIN RANGE HOOD _ <br /> FIOOR Df7AIN AIR HANDLING UNIT— QF.M. __ <br /> V�CUUM BREAKERS STOVE , _ <br /> ROOF DRAINS—RAINLEADERS METAL FIREPLACE 8 CHIMNEV <br /> SINK�SERVICE—BAR,ETC. WOODSTOVE/FIREPLACEINSERT , <br /> SUBTOTAL 509 TOTAL = <br /> PERMIT f PENMiT � ' <br /> TOTAIFEE ! TOTAIFEE f _ <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> iRONi5ET6�CN NEAPSEiO�CN 91DESETBACK PI�NGNECNNUMBEN PL�NLNEGRfEE <br /> iEE �ECEIPT NO <br /> USEZONE lOi�f1E� WGRNTSIiE VAW�T�ON FEE <br /> FEES <br /> OYES ONO <br /> tYVEOfLONST. OCLUP�NCYGROUP NO.OFDWElLIN0UN1T9 <br /> BUILOINO s <br /> 512E OF BLD6. N0.Of S10RIf:5 MAK OCC.IO�D <br /> PLUMBING <br /> MEGNANICAL _ i <br /> 61RE SPRINKlERS REOUIRED O YES ❑ NO ��, <br /> OTHER _ I <br /> PENRLTV <br /> •PPIIWiION�CC9Y PLANSLNECNEOBY APP0.FORISSWNLEBY <br /> �,�(� TOTAL <br /> ��j \ <br /> �'�'�� <br />