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.i f' S'l <br /> APPLICA�ION FOR CONSTRt��TION <br /> ;; PERMIT <br /> n fM Enryr�an evcretl <br /> ,`� GTV OF � 0 <br /> F everett � <br /> '� BUIL�IN6 DEPANTMENT <br /> •� 268-8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> e <br /> ER MeR�DDRE99 GIY IiP PnOHE <br /> ,j Wa���r ;nrr., 772���ul�dc /+ Fvu.�� 3S3 � S?/1"" <br /> ` TEN/Jlf MNI�DOFE89 GIIY 21P MONE <br /> 1 — <br /> .,� MCIIIIECtORDElqNER MMl�D011F!! GIIY 21P MONE <br /> OENEML CONTP�CtON MAII��DREII! Ci1Y I�P MUNf LIGENSE� <br /> 1 <br /> � MECN�NIULfANIPI�CTOR M�II�D�RE55 GiY 21P PNONE 4CENlE� <br /> � /U.c,i. G/u�r ��- 3//a- l{'u sT F��>f/f 9P'Zu/ ZS5-f'31/ �,��ti /G��'/ <br /> f, RUMMMOCONTMCfOF MqL�DOBE89 CItY IIP p110NE L�CENSE• <br /> �� <br /> 1 <br /> � 0./3lOF1�OFK <br /> '� ❑ NEW ❑ AODITION �I ALTEMTION ❑ REPAIR ❑ OEMOLIfION ❑ W0009TOVE/FPPLINSEFT ❑ BUIL�INORELOCIITION <br /> IENN/T Mti110JEMENt ON INTERIOR REMOOEL ONLY GONT�CI VER6pH�NO PNONE NO <br /> �• CONTIUCTMICEOFWORk <br /> � OElCPI!lWORK�NOlOUMEfOOTMF.INVClVEO <br /> � C�awdi,.� Q�� ti f f:v /� <br /> Y �eoueeo�nuaowo IHEREBVCERTIFVTHR�IHAVEREADANDE%AMINEDTHIB�FPLICATIONAND <br /> � HNOW THE SAME TO BE TRUE RND CORRECT.ALL PROVI910N3Of U1N9 AND <br /> lMLOflCRIPTq/l�'�IP(�OWBBELON OR�RAGHi0URt01�1E8� ORCINANCES OOVERNINa THIS TYPE OF WORK WILL BF.COMPLETED WI1H <br /> K WHE7NER SPECIFIED HEREIN OH N01.THEORANTIN60F APERMIi DpEB NOT <br /> '+ PRESUME TOOIVE AUTHORITV TO VIC�LATE OR CANCEL THE PROVISION9 OF <br /> r loT xoCK_— of ANVOTHERBTATEORLOCAILRWREOULATINOCOI:STRUCTIqNORh1EPElF <br /> �V FOPMANCE OF CONSiPUCTION.TH�T 1 AM�UTHORIZEO B'�THE OWNEF OF <br /> 1� THIB PPOPERN 10 PERFORM iNE WORK FOH WHICH ACPLICATION 19 MADE <br /> j� —� AND 1 COMPLI' WITH THE STATE CONTRACTOR3 lAW 18.47 tiCW AND <br /> see.xw w�c <br /> lqN�TUREOi TMCt0110P�UTNp112ED�0ENI ��TE <br /> � X �- �—g�/Y��`7 <br /> �� JMIO.If�REle � � �A �a,�� �✓ ��� �pp��w.6fy O NE�5 UCjNSENO,�NOBUBIMElBM�ME ry <br /> �1 �2 ��� �� �+4I+- �7iQ1�0 <br /> '•� R.UMBINO MECHANICAL <br /> �,� NO. TYP!OR fl1ITUNE OR ITEM FEE NO. 7YPE OF 80UIPM8N� FE! <br /> �� WATERCl08C1(TOILEn A/C—NHNDLOUNITS—H.P. <br /> � BATHTUB FORCED AIR BVSTEM9—flT.U. M EA <br /> � UVATORV�YVASHBA9IM UNITNEATER9-9T.U. M <br /> '1j BHOWER CLOTME9 DRYERS — <br /> I NITCHEN 81NK 6 DIBP. VENTILATION FAN <br /> DIBHWABHER RANOE HOOD <br /> LAUNDRV TMV WATER HEATER <br /> CLOTHEB WA9HER WOOD STOVE <br /> URINAL METAL FIREPLACE6 CHIMNEV <br /> '� I� DRINKINO FOUNTAIN FIREPLACE INBERT <br /> � ; flOOHDMIN HEATPUMP <br /> ! BACKFLOW PREVENiERB OA9 PIPINO _ <br /> � _ ROOFDRAINB—RAINLEADERS EXH�USTFAN — <br /> BINK�BERVICE—&11;ETG) <br /> � <br /> � <br /> 1 SUBTOiAL 6 SUBTOTAL S <br /> i -- <br /> PEFMIT S PERMIT i <br /> TOTALFEE { TOTALFEE t <br /> iRONf6E1MGlt REAR6EIB�CN li0E0EIBI�CK �IANCMECI(MUMpl11 F[! 11[ClIRMO. <br /> i ueezoNe �oiu�u v.c.nrone FEEB WLUATtON FEE <br /> { ❑YEB ❑NO — <br /> i BIdlDINO <br /> IYVEOiCONBT. OLCUWINCVOAOUP NO.OiOWELLIN0UN119 <br /> u������u PLUMBINO <br /> � eua a s�oo. Na a sroan e osuc occ iwu <br /> 1 ❑r MIiCMANICAL <br /> oN <br /> NEIUNfUR11G1qN O7HEH <br /> � <br /> 1 IIREliPINRLlRlREWIPED O VE! O NO 9T�'iE BUILDIN09URCNAROE <br /> i <br /> � � _ <br /> '1 9TAT"cFNERaYSURCHAROE <br /> � �rruurron�cc er vuHa�vra er <br /> PUBLIC WORRS <br /> i <br /> �OTAL <br />