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`.�;APPLICATION F(rr'� <br /> '"""'°'"" CONSTRUCTION °�"°" <br /> Cltr OF <br /> everett PERMIT e <br /> BUILDINO DEPARTMENT <br /> 259•e�45 TO BE COMPLETED IN INK • PLEASE PRINT <br /> ❑DEMOLITION ❑COMBINATION ❑ BUILDINO ❑ MECHANICAL ❑ PLUMBINO �ION <br /> OWNFR MML�DOREl1 CIIY ItP pNOHE <br /> �2Amc�-F .x.►e.. -��//.,2CCn/.9r ��.I�J �Yern/l�rcL l�'A '7Ro�� "7y- � �45 <br /> ;RCNIfEGIOROEalONFO M�IL�DDREBB CITY !IP PNONE <br /> (-�nn}��c .��.��n,� �5��;,i �.�lc�l rJE /,�-�In� �i,n�cn� k�A 98r.3� �4.�3 � il-/l <br /> OENER�LLONIq�L10N MeIl�0�RE79 CIIV SIP PHONE LICENHE• <br /> MECNIINIC�L LONiR�CTOq M�IL�OONE!! LiTV iIP PHONE UC[N!E• <br /> PWMl�NOCONIP�CIOR MMl�00AE9� CIIY IiP PNONE LiCENSE• <br /> Cl�l70i WORIt <br /> �NEW ❑ AODITION ❑ ALTERATION ❑ PEPAIR ❑ DEMOLIiION ❑ WOODS70VE/FRPL.INSERT ❑ BUILDINO RELOCA710N <br /> V�ll'wIION O�n]NM ICOlT Of M�IER4L9 PWS I�BOPo <br /> � ��o�. n�� <br /> oeacniee xronK <br /> Z.i.�-��e.. ,f- r nIG N /�t,uMin/ �eJ� <br /> uec or suno��a <br /> � I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS AP• <br /> - � PLICATIONAN�KNOWTHESAMETOBETRUEANDCORRECT.ALL <br /> � lEO�IDElCRiP1�ONOfPpOPENfY�BtlOWNBEIOWORIIUCNFWRLOPIEl� pROVI510NSOFLAWBANDORDINANCESOOVEFNINOTHISTVPE <br /> OF WORK WIIL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br /> ioi_e�aK—or IN OR NOT.THE ORANTINO OF A PERMIT DOES NOT PRESUME TO <br /> OIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ' ANV OTHER STATE OR LOCAL LAW qEQULATINO CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SION�TUREOFCONTR�GfORON�UTNORIZED�OENT DATE <br /> �/ C p� � � - R7 <br /> PROJECl�0UNF6! �PP4G�HipCiT BWiHE L�CENbENO <br /> E. C •'l C� ''. <br /> PLUMlINO MECMANICAL ' <br /> NO. TYPE OF FIXTUNE FEE NO. TYPE OF EOUIPMENT FEF <br /> W�TEP,CLOSET T04E AIRCOND.UNITS—H.P,EA <br /> B�THTUB REFRIOERAiION UNI18—M.P.EA <br /> ��V�TONY WA9H B�SIN BOIIENS—N.P.E�. <br /> BNOWER O�9 FlFED AC. UNITS—TONNAOE EA <br /> NITCNEN 91NN 6 DISP. FOPCED AIp 9Y3iEM5—B.T.U. M E�. <br /> OISHW�SHEf7 WALL HE�TERS—B.T.U. M <br /> UUNDRYTRRV UNITMEATEflS—BT.U. M <br /> I.LOTNES W�SHER EVAPORATIVE COOLERS <br /> W�TER ME�TER CLOTMESDRYERS <br /> URINAL VENTILATION FAN <br /> ORINNINO FOUNiAIN RANOE HOOD <br /> FIOOR DRAIN AIR NRNDLINQ UNIT— C.F.M. <br /> VACUUM Bf7E�NERS 9tOVE <br /> ROOF OR�INS—HAINLEADER9 MEiAL FIREP�ACE E CMIMNEY <br /> 91NN SElIVICE—BAR,ETC. WOOD9TOVE/FIPEPLACE INSEtiT <br /> BUBTOTAL 9UBTOIAL � <br /> PERMIT t PERMIT 1 <br /> TOiALFEE � TOT�LFEE t <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> lPON�BEIB/�GM OE�NSEI9�GK SIpEeETB�GK VUNCNEGNNIIMBER P1�NCUECKfEE <br /> fEE AECEiP'YO <br /> USE iONE �pl�IIE� V�C�NI SilE -- <br /> ❑YE9 �NO FE[� V11lUl1TIOM �[F <br /> rvPE Of CON91 OCCUP�NCY GROUP NO OF DWFLLINO IIHIfS <br /> BUILDINO f <br /> 8Rf Oi B100 NO O�S�pBIE9 M�%OCG IOAD <br /> PLUMBINO <br /> MECN�NICAL <br /> FIPE SPRINKLEHS REOUIRED ❑YES O NO <br /> OTHE11 <br /> —` PENALTY <br /> �PFLI��IION1f,� BY PL�NSC��fGKEOBY �PPp fOR15SU�NGF V -- <br /> / � TOTAL <br />