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`�T��PPLICATION FOK� ���,�„ <br /> ,".`".ro'"" CONSTRUCTION 0 <br /> ���o, <br /> everett PERMIT <br /> BUILD�NCa DEPAFTMENT <br /> 259•8745 TO BE COMPLETED IN INK• PLEASE PRINT <br /> O DEMOLITION ❑ COMBINATION O BUILDINO ❑ MECHANICAL ❑ PLUMBIN6 ❑SIGN <br /> pWNER ��IL�DURE9! CIfY IIP P��ONE <br /> 1tIf1111�ROESiONF11�C•�(,�M�'s�9g �erC� Z�P VIIONF. <br /> OENEN�I CONIH�CION M�II�OORE9S G�1Y ZiP FHONE �iGEN9E• <br /> l M n�Tl A Tl� � �q •n c. �O �- X 2 7/� (.ynnuao� ��Gl�-(i 778 _�i/O � <br /> NECN�N�C4 GONIO�CIOq V M�I��OOBE39 UIY 21F PHONE l CEN9E <br /> OWM0INOCONIP�ClO� M�ILIIUDRES! GItV IIP PIIONE UGENSC• <br /> CUS]O�WORK <br /> ❑ NEW ❑ ADDITION ❑ AITERATION ❑ REPAIR �EMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDtNO RELOC�110N <br /> W W��ION OI WORn ICOlI Of M�fE�l�l9 VlU9 UBORI <br /> Z�(p0 O C� <br /> DE9CN�BE WOAK <br /> J � � � S <br /> c oreuno�Na I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED tHIS AP• <br /> PIICATION AND KNOW THE SAME TO BE TRUE AND CORRECi.ALL <br /> lE6�L0ESC111P110NO�P110>EAfv�SNOWNBEIOWON�tT�CNi0U11COVIE:� PROVISIONSOFLAW3ANDORDINANCES60VERNINGTHISTYPE <br /> $Ce Nrtar�h�d OFWORKWILLAECOMPLETEDWITHWHETHERSPECIFIEDHERE• <br /> io�—eioc�.—or IN OR NOT.THE ORANTIN�OF A PERMITDOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANYOTHER Sl'ATE OF LOCAL LAW FEOULATINOCONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTHUCTION. <br /> 91 TURE Of C NiMCTOR OR AUTIIORIZED�OENI U�fE Ur /�_�7 i <br /> f� �•��Gcn. H G.�L <br /> f� J 6 <br /> ROJECt�OOPEB! � AN�BCIIY 8�91NFH9liCENSE NO <br /> a� � Gs,� � <br /> PLUMlINO MECM�NIC�L _ <br /> NO. tYPE OF FIIITUIIE FEf NO. 7YPE OF EOUIPMENT FEE <br /> WI1TEft CLOSET TOILED ��N COND. UNITS–H.P.F.11. _ _ <br /> B�THTUB HEFRIOERQION UNIT9–MD.EA. _ <br /> UVAIJRV(MU9M BA91N BOII.ERS–H.P.EA __ <br /> SIIOWER OAS FIREO AC.UNII9–TONNA6E EA _ <br /> KITCNEN 9tNK 6 DI9P. FORCED Alq 9YSTEM3–B.tA. M ER. <br /> OISHWA9HER WIILLHEAIER3–B.T.U. M <br /> L�UNDRYiRAY UNIIHEATERB–B.T.U. �1 <br /> CIOiHE9 WARHER EVAPOR�iIVECOOLEN9 <br /> WATER HEATER CLOTHE9 DRYEAS <br /> URINAL VENTIL�iION FAN _ <br /> DRINKINO FOUNTAIN RANOE HOOD _ <br /> FIOOR UR�IN _ AIR HANDLINO UNIT– QF.M. _ <br /> VACUUM B�EAKERS STOVE — <br /> ROOF OP�INS–R�MLEADERS METAL FIREPUCE 6 CHIMNEv _ <br /> SINN SERVICE–BAR ETG) WOODSTOVE/FIREPLACE INSERT <br /> BUBTOTAL 6UlTOTAL � <br /> PERMIT / PERMIi � <br /> TO�l1l FEE � TOTAL FEE � <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> �RONiSE10�CM nEeRS[lO�GN SI�ESEIB�CN PI�NCNECKNUMBEA PUNCNECKiEE <br /> fEE �ECEIPI NO <br /> U9ElONE lOI��E� y���NT�RE <br /> i[!! V�IU�TION �!f <br /> ❑YE9 ONO <br /> IYPE Of CON51 OCC�IP�qtv G�OUP NO OF DWELLINO UNIt9 _ <br /> BUILOINQ f <br /> SRE O�BlUO NO UI SIO�iE9 M�k OLC 10�0 <br /> � PLUMBINO <br /> MECII�NIC�L <br /> FIPE SPRINNLERS REOUIRED U YES ❑ NO <br /> OTIIEP <br /> PEN�ITY <br /> evn�i��no���cr, 9v PUNSC��FGKLDBY �PCR IOOISSU�NGEBY �— <br /> T0T11L <br />