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r <br /> i..P'PLICATION FO1� ���,�„ <br /> '".`""'"" CONSTRUCTIUN � <br /> pn Of <br /> everett PERMIT <br /> BUILDIN�3 DEPARTAAENT <br /> p5g-g745 TO BE CQMPLETED IN INK- PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING �MECHAidICAL ❑ PLUMBING � O SIGN <br /> OW�iER MAR�UDR[99 CITY /3,� ZIP PNONE <br /> X ' /�/�y�,� Si!�y3' i'v ��U%/1 `� ,ri,c,vn /1n:er_-v�f:in� i�nu�rr ��c;:U�d�n 9E�2c� Z$9�/// <br /> •RCNII[GIOADE916NER M�IL�DORE39 Cl;v 21v VIIONC <br /> X Ly J�IJ,t�S^N C(��'G�r`l�A'IS /07�b /I��I/o/n� J�l, �111>_= w� `�f�/.,'� ZSl-Go7f <br /> OENCMICO���A�G1ON Mq��ODtiCS9 C�IY IIP f'NONE � UCENSE• <br /> x ��virn crn��%r-r� i�cu �7zz a��.4Y�uF �7ZZ r�F'-�zrJ7 ,�ti� �I5��! /88c� <br /> MECN�Ni��L GON�n�GIOfl M�IL�UDAE99 LIIY ZI P��ONE ✓. IICCNSE• <br /> y� 11.I-�D/��.� C�!'n'. ` 1'�L'C��/c^N 2�ZZ. CD�-�7'�' �U� � � /� � � A I G����YJ <br /> OLUMlINOCOHfH�CTOR MML����E59 ��TM Z�P P��H��OI � 'I��� � <br /> 4 <br /> C1�5]Oi WORN <br /> ❑ NEW � ADDItION �ALTEPATION ❑ HEPAIR ❑ UEMOIITION ❑ WOODSTOVE;FRPL.INSERT ❑ BUILOINO RELOGAT�ON <br /> V�IU��ION O�WORIt ICG51 OF MA�E�i�LS PLU9 LABOf11 <br /> DElLR�SE WOPtl . <br /> usEor eunoixa I NEREBY CERTIFY THAT I HAVE READ AND E%AMINEO iHIS AF• <br /> PLICATION AND KNOW THE SAME TO BETRUEANO CORRECT.AI.L <br /> LEO�tDE9G��PfIONO�PROPEfIfv�9NOWNBEIOWOR�i1�GN(OUt1COPIE81 PROVISIONSOFLAWSANDORDINANCESOOVE7N�NOTHISTVPE <br /> QF WORK WILL BE COMPLETED WITH WFIETHER 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 /> ANYOTHtR STATE OR LOCAL LAW REGULATIN6 CONSTRUCTION <br /> . � OR THE PERFORMANCE OF CONSTRUCTION. <br /> \ <br /> F�ONhTUAEOFCONIf1ACTORORAUTNOf112E0�GENT D/1E <br /> X <br /> VRplEGI��OHE55 APPLIC�NiS LIfY BUSINE53 L�CENSE NO. <br /> �9r5 ���;,.,1, l--vEaF1T [�n `��I�o/ � �/B� <br /> �IUMSINO MECHIINICAL <br /> NO. Tl'PE OF FIKTURE FEE NO. T'PE OF EOU:PMENT FEE <br /> WATEN ClOSET(TOILE A�R CON�.UNITS-H.P.EA. _ <br /> BATHTUB i7EFRIGERATIOY U111T5-H.R E0. _ <br /> UVATORY�WIISN BASIN� BOILEHS-H.P.EA. <br /> SHOWER GAS FIPED AC.UN�TS-TONNAGE[A <br /> KITCNEN SINK 8 DBP. FQPCEO AIR SYSTCMS-B.T.U. M E�. _ <br /> DISHWIISIIER WALL HEATERS-B.T.U. M <br /> LIIUNDRVTRAV UNITMEATEFS-B.T.U. M _ <br /> CLOTIIEu WASHER EVFPORATIVE COOLERS _ <br /> WATER HEATEA CLOTHFS DRYEPS <br /> UAINAL VEIJiILAi�ON FAN � <br /> Ot71NKIN0 FOUNTAIN AANOE HOOD D ^J 7 , . <br /> fIOOR DR�IN MIR MANDLING UNIT- C.F.M. <br /> Krfe .� �o,��� - <br /> VRCUUM BREAKERS I STOVE Q�__� <br /> ROOF ORAINS-FAMLEAUERS METRL FIREPUCE 6 CHIUNEV <br /> SINN SERVICE-BAR.ETC. � WOODSTOVE/FIREPLACE INSERT �1.f S� L _ <br /> ! <br /> BUB iOTAL SUB tOTAL s <br /> PERMIT ' C PEPMIL • <br /> TOTIILFEE i TO7�lFEE � � <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERS(�NNEL <br /> lMON15E7C�fN PE�IISEIB�CK SIpESETBACN PL�NCHECNNUMOER PUNC��ECNfEE <br /> fEE PfCEIPiNO. <br /> USE 20NE LOf RRE� y���HT SILE <br /> FEE! V�LU�TION FEE <br /> pYES OIJO — <br /> TYPE Of COi191. OCCUf'/�NCY GROIII' NO.Of DWElLINO UNITS <br /> BUIlDINO S <br /> 34E Of BI UO NO Uf SfONES M�N.OLQ LO�O ' <br /> P�UMBING <br /> MELHANICAI <br /> FIRE SPRIN!(IERS REOUIRED ❑VES ❑NO <br /> O7NER <br /> PEN�ITY <br /> ♦FPUr�11pN�CC.B� f 1�N5 GIE(ICLO BY ���A.�0f1 I$$U�NGE 0Y — <br /> �-�, TOT�I <br /> �} <br /> ... . � . . v. . . J . . <br />