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�.r''PLICATION F0I�1 evercn <br /> tn�Ewrymn CONSTRUCTION e . <br /> an oF <br /> everett PERMIT <br /> TO BE COMPLETED IN BLACK INK— PLEASE PRINT <br /> eui�ow� oePr. <br /> 259•8745 � COMBINATION ❑ BUILDING ❑ MECH�NICAL ❑ PLUMBING ❑ SIGN <br /> OWNEP M�ILADORESS CITY 21P PNONC <br /> Lc,�,��-S S�P��i' 2115 E�Eg€J�' �✓[ 'F✓C�Err982o1 ZSZ 3G88 <br /> 11RCNITEC�SIONER MRIL�OONE59 GTY Zi�--�ONE <br /> �o� �'�+�mP� o�i 38o2C.o�C3�( �� '� �9 3►3�— <br /> OF�NERALCONTP�CiOR M�ILF��RESS CITY ZIP PNONE LICENSE <br /> � p � rNc — <br /> MECMANIG�LCONiMCTOq M�IL�UDRESS CI7Y ZIP P��DNE LICENSE• <br /> 11 <br /> PLUMBINOCONTP�CTOR MRILADORESS CIIY ZIP MIONE IICENSE• <br /> � � �� <br /> CU890F WORK <br /> � NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODS70VE/FRNLINS[n`T ❑ BUILDINQ RELOCATION <br /> �V LU�TIDNOFWONKI�9TOFM�TERI�LBPLUSL�BOR1 <br /> � �� <br /> pEBCRIBE WOR � � <br /> 22 ' <br /> ueeoreuaoiNa 1 HEREBY CERTIFY AT I HAVE READ AND EXAMINED THIS AP• <br /> Li PLICATION AND KNOW THE SAMETO BETRUEANDCORRECT.ALL <br /> lE0 LDEBGRIPTIONOFPPOPERTYI9MUWNBELOWO �T��CHFOU1iCOP1E9 PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYFE <br /> ��'—' OF WORK WILL BE COMPLETED N'll H WHETHER SPECIFIED HERE- <br /> �or_e�oc�—or IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUMETO <br /> GIVE AUTHORITY TO VIOLNTE OR CANCEL THE PROVISIONS O� <br /> '`d��r /( 1"�:��t� F�l' �� ANYOTHERSTATEORLOCALLAWREGULATINGCONS7RUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIGNATUREOF ONiRR TORORAUi R DAQENT DATE <br /> r�(�l/ J A A \ Y-11 JLIJF'� p�� ' I � � �� <br /> PROJEGTAOORES GA I�F�v�A �rruc NI'SGIIYBUSME UCENSENO. <br /> D� SSI <br /> PIUMBINO MECHANICAL <br /> NO. TYPE OF FI%TURE FEE NO. TYP[OF EOUIPMENT FEE <br /> WATER CLOSET TOILE AIR COND.UNITS—H.P.EA. <br /> BATHTUB REFRIuERATION UNITS—H.P.EA <br /> LAV�TOHV WASH BASIN 901LER5—Ii.P.EA. <br /> ' SHOWER OAS FIHED AC.UNITS—TONNAOE EA <br /> KITCHEN SINK 6 DISP. FCRCED AIR SYSiEMS—B.T,U. M EA. <br /> DISHWA9HER WALLHEATERS—B.T.U. M <br /> LAUNDRYTRRY UNiTHEATERS—B.T.U. M I1J <br /> CLOTHES WASHEF EVAPORAiIVE COOIEPS <br /> WAtEF HEATER CLOTIIES DRYERS <br /> URINAL VF.N➢�ATION FAN , <br /> ORINKIN6 FOUNTAIN RANCiE HOOD <br /> FLOOR DRAIN AIR HAN�LING UNIT— C.F,M. <br /> VACUUM BREAKERS SiOVE <br /> ROOF DMINS—RAINLEADERS METAL FIPEPLACE 8 CHIMNEV <br /> SINK SERVICE—B�R ETC. WOODSTOVE/FIREPLACEINSE�7T <br /> � SUBTOTAL SUBTOTAL f <br /> PENMI7 f PERMIT • <br /> TOTALFEE S TOTALFEE ! <br /> THIS Pc�RTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> FRONTSETBACN BEpN9CTBRCN SIOESEI6ACK PLANCN KNUMBEB �NCHECNFEE r <br /> � , �` r'J I r.�.'� I FEE��{�•' � f1ELEIVT NO. (L,CCi , <br /> � � �� �� �'� � <br /> 1 <br /> USEZON� ./ LOT�HEA VALANT9ITE FEES ' VALWTIDN' FEE <br /> C� � E9 ONO . <br /> .� � <br /> TYPEOFCONSL � OGCUP�NCY6ROUP NO.OFDWELLINtlUNlT9' � ' ' - � , <br /> �►h� B-`Z- —' auaoiNo4isv (o a /S/�/ov � <br /> SIZE OF BLDO. NO.OF STORIEg MAX OCC.LOAU <br /> . . �ZO� /.' . . . . . O)CJ .. . PLUMBIN6 <br /> -lAECNAWICAL �� <br /> FIRE SPRINKLERS REOUIFED ❑YES O� � . � � '.` � � <br /> � . . _ . A7NEB� � <br /> . . . .. -�ilIUE71�� �_ <br /> �PPLIC�TION�CC.9Y PLAN9 CIIECNEU OY �PPR FOR ISSU�NCE BY � /�/^ /�/� , <br /> TOTAL `� / 5 hl <br /> _�:�i� �� �� <br />