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, ,PPLICATION FO._� ���.�n � <br /> c`�'°'�" CONSTRUCTION O <br /> everett PERMIT <br /> BUILDING DEPAATMENI TO BE COMPLETED IN INK- PLEASE PRINT <br /> 259�8745 <br /> ❑ DEMOLITION ❑ COMBINATION Cd�OUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> Ow��EA <br /> MAII�ODRE99 CIfY 21P P��ONE <br /> AU�JNy EvEa�r� �187D"3 �53-- �.;!i4 <br /> �{� E��ERl>�Gn� CA��itPy NS� G� [in Z�o PIIONE�'a}7.�$3(. <br /> �fKNRCClOf10E9�ONER M�R.�ODPE93 <br /> 3C. � C�ou �'7�to �i.n,.� oec. `1��03 .Tr_M��ac34�cr <br /> M�u�E Pu�wi�Y CD��;iRU�"i16rJ Cs� I�.k- (�a>y��.�e�w <br /> OENER�lCON1R�LtOR MMI��OREss CITY 21� ONE LLE 9E <br /> JL 1i1l,tJE QL���'•���r CI71JSiRUL710N C10'•lNL PD I3CAc 'a�7k0 FORZ.Ai�OPE 9 c�o 8 �'cMi�BcE3 EI �D <br /> MELMnNIC�LCON1ReGfOq M�IL��ORESB <br /> PLUMBIN7 GONTlIACiO� <br /> M�I�IDORES9 LIIY 21P PIIONE LICENSE• <br /> CL�SSOf WORN,�,/ <br /> ❑ NEW LY ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ �NOODSTI7VE/FRPL.INS[RT ❑ BUIlDIN6 AELOC�TION <br /> vuwi�oN or wonr,icosi or u.icmnis r�us ueon� <br /> � �O c�o�7 <br /> pLSCRiPE WOPN <br /> .� w,oi ta� To R r��sa�?r t-cn - <br /> ueeorew�oiNo I HEREBY CERTIFY THAT 1 NAVE ficAD AND EXAMINED THIS AP• <br /> ��,�� � r�+,,��� L(ytkG7S pLICATIQNANDKNOWTHESAMETOBETRUEANDCORRECT.ALI <br /> LE011LDElCRIP�IONO�PAOPE�tY19NOWNBEIOWOR�iT�CN(OUAGOPIE81 pROVI510NSOFLAWSANDORDINANCESGOVERNINGTMISTYPE <br /> OF WORK WILL BE COMPLETED WITH WHETFiEA SPECIFIEO HERE• <br /> io�_—e�ocK_a� IN OR NOT.THE tiRANTING OF A PERMIi DOES NOT PRESUME TO <br /> GIVE AUTHORITV TO VIOLATE OA CANCEL THE PROVISIONC OK <br /> ANY0711ER STATE OR LOCAL LAW REGULATING CONSTRUCtION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SI6NATU(1E O!CONTR4GTOR OR AUiHORIZ[�RGf.Ni UATE <br /> � 1�- X �� ��zIB� <br /> Gvern�Pl�em� <br /> PROJEGi��ORE55 � RPPIIL�N i5 CIIY BUS W ESS IICENSE NO <br /> �ts�� ��Acx.�a ��cP.err wA qa�3 <br /> MECHANICAL <br /> PLUMBINO FEE <br /> NO. TYPE OF FIIITURE FEE NO. TVPE OF EOUIPMENT <br /> W4TER CLOSET(TOILEI� _ AIf7 COND. UNITS—H P.EA. __ <br /> REFHiGERATION UNITS—H.P.EA. __ <br /> BAiHTUO <br /> LAWTOFYIWASNBA$IN� _ OOILERS—I/.P.EA. <br /> — GAS�IRED 0.C.UNITS—TONIIAOE EA _ __ <br /> SHOWER — <br /> NITCHEN SINN 8 OISfl FOACED AIR SVSTEMS—B.T.U. M EA_ <br /> WALLHEATENS—B.T.U. M <br /> DISHWASNER <br /> LAUNDRYTRAV _ UNITHEA7ER5—B.T.U. M <br /> CLOTHES WASHEF _ EVAPORATIVE CUOLERS <br /> LLOTNFS Df7vE�5 — <br /> WAIER HEAIER — ---" <br /> VENTILATIO��FAN — <br /> URINAI — <br /> DRINKIN6 FOUN7AIN _ RANGE HO00 <br /> — AIR IIANDLING UNIT— C.F.M. <br /> FLOOR ORAIN <br /> VACUUM AREAkERS S10VE <br /> ROOPORAINS—A��INLEAOERS METALFIFEPLACE6 CNIMNEV <br /> SINK�SERVICE—B�R.E1C. _ WOODSTOVE/FIREPLACE INSEIIT <br /> SUBTOTAL f <br /> SUB TOTAL = <br /> PEBMIT 3 PERMIT -- <br /> TOTRLFEE / TOiRLFEE s <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> P��N CNECN NUMBE(1 PLAN GHFCN f E E <br /> fHONi5EI-1GR P[�RS�B�C1( Si0ESE1B�CK � � I � ��y I f[E Z � � �� �EGE�p��r-'J(` <br /> �_ /G'� <br /> UiE ZO��E LOl Rf1ER y�C�NT S IF. FEES VALUATION fEE <br /> F� � OVES L�10 " <br /> l.f <br /> TYI'E Oi COH51 OCCUP�NLY GROUP NO�OF OWELlINO UNITS <br /> �� � � ^ I O BUILDIND f IG 7 � ( J <br /> 5�2E OI'B104 HO Of SA10/RIE9 MA%OC^G/LO���/ ' <br /> �, 3aS � /V �� / /Y""f / PLUMBINO _ <br /> MECNANICpI <br /> FIRE SPRINKLERS PEOU�RED ❑YES NO otHEa <br /> PENRLTV <br /> A1`PlIG4lIONRLC BY flANSCNEGNEDBY �PPA-�ORISSUANGEBY <br /> � � T�.�� <br /> M . �1� , �J`' � " <br />