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• e_ <br /> �. APPLICATION F'OR � <br /> ' '".E"'°'"° CONSTRUCTION e1 <br /> cm oF t <br /> everett PERMIT <br /> � TO BE COMPLETED IN BLACK INK— PLEASE PRINT <br /> BUILDING DEPT. <br /> 259•8745 ❑ COMBINATION � BUILDING ❑ ME�HANICAL ❑ PLUMBING ❑ SIC <br /> ' OWNER MAILADDRE55 Gitt IIP PHON[ <br /> ��cki+acto wN��is.v Po.� '� c. �- W.o..voc q�a1�1 �4A- sSo.G <br /> ' �RCh�7ECTONDE5IGNER M�IL�ODNE55 G�iY ZiP PMONE <br /> 'SP�cZQf.aM DRA���.►C SNo.ac�w.�s.a qeaao �3q-'z_�q7 <br /> GENF.PeICONTPACTOR � MAiLApORESS CiTV ZIP PHONL IICEN'� <br /> , �ALL1�i�ER- cWs'S 'P.O.S .3 MpoNrta� 46i�t 74�-�So� yw`��ot� <br /> MECH�NIC�LCONiP�LTOfl M�IL�DDNE55 GITY 21V PMONE tICEN' <br /> PLUMBINOCONTRACTOR MMLPDORE55 GITY 21P PHONE UCEN: <br /> CL�SS OF W DRN <br /> � NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/fRPL.INSERT ❑ BUILDING RELOC! <br /> W WATIONOF WORN�COSTOf M�TERUL9 Ply!'jLRBQ� <br /> �^ /�/�/� Z <br /> �. �SO � 000 Y ��YY/C'L"�FJ' � � <br /> -� <br /> pESCP18E WORN � � , <br /> !�1 �..> O�F�� 1�L0 e, . m <br /> � USEOf BUIIDING I HEREBY CERTIFY 7HAT I NAVE READ AND EXAMINED THI <br /> O'�����, +�', PR��C SNOp PLICATIONANDKNOWTHESAMETOBETRUEANDCORREC� '-"" <br /> . LEO�LOESCPIPTIONOFPROPEFTVI5MOWNBELOWOR�TT�CMFOUNLOPIES) PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHIS '� � <br /> . . OFWORKWILLBECOMPLETEDWITHWHETHERSPECIFIEDI� N = <br />( L0T—BLOG�OF INORNOT.THEGRANTINGOFAPERMITDOESNOTPRESUA rn <br />� � GIVE AUTHOHITY TO VIOLATE OR CANCEL THE PROVISIO� c o <br /> Lo�S � 2 3 � 4 4��b��L. � � ANYOTHERSTATEORLOCALLAWREGULATINGCONSTRUC mo <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> c-� <br />' aTVC4C�T: ��� e0' a l 1� r.dAl.ov� T� Ew�((� -I e <br /> f SIGNATIIRE OF CON7 CTOR OP AUiHOR12ED AGENT DATE O 3 <br /> G \ /�'I � �1.PZi � 4AGi 1e , R=c�.��� •C i�a . co - X ..� / � �./ m M <br /> � �J <br /> PROJELTAODRE59 APPI /.NTSGItVBU5irvE55L�LGNS[NO C = <br /> D —1 <br /> 3201- Beoaawa � � <br /> I PLUMBINO MECHANICAL � N <br /> NO. TYPE OF FI%TI1flE FEE IJO. TYPE OF EOUIPME4T FEE �7 <br /> I — AIR COND. UNITS-NP.EA. � 3 <br /> WATER CLOSET(TOILE7) - <br /> BATHTUB f7EFRIGENATION ONITS-H P. EA. � m <br /> I � � LAVATORV�WASH BASIN� B BOILERS-H.P.En_ m� <br />� SHOWEfl GAS FIRED A.C.UNITS-TONNAGE EA � • � <br /> ��� KITCHEN SINK 8 DISP. -' FORCEO AIN SVSiEMS-B.T.U. M EA. � m <br /> I - ' '� DISHWASHER � WPLL HEATERS-B.T.U. M 3 � <br />� „ = LAUNDRVTRAY = UNITHEPTERS-B.T.0 M R1 <br /> CLO7HES WASHER EVAPORATIVE COOLERS Z � <br /> -� r <br /> s WATER HEATER C C� CLOTHES ORYERS � m <br /> a <br /> � URINAL VENTILATION FAN A <br />� �I �' DRINKING FOUNTAIN — � RANGE HOOD � <br /> _ _ <br /> --� FI.00R 0l7AIN AIR HANDLING UNIT— C.F.M. � <br />� 1 ' — <br /> -- VACUUM BREAKERS STOVE <br /> ROOF OFAWS—RAINLEADERS METAL FlREPLACE 8 CHIMNEV = <br />' SINH SERVICE—OAR,ETC. � WOODSWVE/FIFEPLACE INSERT N <br />� Z <br /> O <br /> ti <br /> n <br /> rm <br />� SUBTOTAL SUBTOTAL 5 <br /> PEHMIT f PEPMIT � <br /> h TOTALFEE t TOTALFEE f <br /> I <br />� THIS P!�RTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />' ' FRONT•ETBAf PEARSETB� K SIOESETBA PUNCMECKNUMp[B PIANCHECNFEE <br /> N LI Q Q S� /�/S' � FE�3�'s �o AE7�P�,o�.� y <br /> � USE20NE LOT�NG� y�CANT511E VAW�tION FEE <br /> fEES <br /> ' iYC$ t]ND — <br />' � ttPEOFGONST. OCCUPANCYGROUP NO.OFDW[LLINOUNIIS _ <br /> �^ euaou+o t(9D��� �oSB � <br /> 512[OF OLDG. NO.OF STORIES MA%.OLG LDAO <br /> PLUMBING � <br /> � MECHANICRL BQ C <br /> ' FIRE SPRINKLERS REOIIIRED ❑VES ❑NO <br /> 0T11ER <br /> � - PENALTV . <br /> AVPLiCATION ACC.BY PL�NS CIIECNEO BY APPR FOR ISSUANLE OY <br /> ^1� / TOTAL <br /> ���. ��� �MG/ r / <br /> 7 �/o Nl��c.d� P� .�t12�li; <br /> , M,�gr�,A�c./tGac. P��v1rT ?� � <br />' • ��7p.� !aY c�7� P,�rod 2b <br /> . . Gv.li/Lei1�(GhlLLJ v�ln Y_. <br />