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,�E„��„ ���'�PPLICATION f0�:� <br /> �'°` CONSTRUCTIOR! `"°'�" <br /> everett PERMIT e <br /> BUILDINO DEPARTMENT <br /> 2b9•8745 TO BE COMPLETED IN INK• PLEASE PRINT <br /> O DEMOLITION ❑COMBINATION ❑ BUILDINO ❑ MECHANICAL ❑ PLUMBIN(i O 81pN <br /> OWNER M�IL�OONEH! GIfY 21P PNONE <br /> Ed Gilliland 414 Center Rd EWerett 98203 252-4920 <br /> MCHITEGTOPOEli6NER 1.'.L110DNE8! CITY 2iP PNONE <br /> OFMEMLGONTNACTOR MqI.�OpRE49 CRV LICENlE• <br /> btnerett Bldrs. Inc. 5606 �4ergreen Way Et�erett 98203 P 353-7161 EYIItEB*301pN <br /> MEGHIINIC/iLCONTMCTOq M�IL�UDRE68 CIIY 21P PNONE IICENlE• <br /> RUMlINOLONTMGfOR MUL�DORES! C11Y ZIP PIIONE IICEN6E• <br /> CL�!!Oi W011R <br /> Q NEW ❑ ADDIt10N Q ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WODD9TOVE/FRPL.IN9ERT ❑ BUILDINO RELOCATION <br /> V�l WTION OF W0111t�OplT Of M�IERULD PlU6l�B01p <br /> 8825.00 <br /> 0[/CIII�[N'ORK <br /> uu�no,pfE and reroof exisitn reaidence 22 s . c Install (,Uttera insulation in roof. <br /> S�� I HEpEBY CERTIFY THAT I HAVE READ AND E%AMINED THIS Ap� <br /> LfO�LOE�C111MqNOFPROiEpTV�pNOWHBEIOWON�tT�CNiq1qCOAEl1 P��CATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES 60VEHNINO THI3 TVPE <br /> �or_noc�or OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED NERE• <br /> IN OR NOi.THE ORANTI NO OF A PERMIT DOES NOT PqESUME TO <br /> 4OY9-OOO-OZl-OOWi (iNE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OK <br /> ANVOTHER STATE OR LOCAL LAW REdULATINO CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTpUCtION. - <br /> BIONATUPEOFCONTR�CTORONAUTMOR12EO�OENT DATE <br /> X � �/ �/ <br /> r�o.iccr�oo�u /� I I <br /> �PPIIC�NT!CIIY BUSINEHS LILENSE NO <br /> 419 Center Rd �erett, Wa 98203 <br /> KIIM�INO MfCHANIC�L <br /> NG. T1TE Of RIXTUII[ F[[ NO. TYP[Of EOUIMNENT fE� <br /> WAfERCLOBET TOILE 111RCOND.UNITB-M.P.EA. <br /> MMTU! REFRI6ERATION UNITB-M.P.EA <br /> UVI1TOqY WMHlA81 BOILERS-N.P.EA <br /> SMOWER OA9 FIRED AC.UNITB-TONN�OE EA <br /> 1(ITCMEN BINK{D18P. FORCEO AIH BY8TEM3-B.T.U. M EA <br /> DI6HWA8NER WALIHEAlER9-B.t.U. M <br /> LAUNORYiRAY UNITHEII�EH9-B.i.U. M <br /> CIOTMEB W�BMEq EVAPOMTIVE COOlERB <br /> WATEN NEAiER C�OTNEBDRYER9 <br /> UIIINAL VENTILATION FAN <br /> DIIINKINO FOUNTAIN RANOE MO00 <br /> fIOOR DMIN AIR M�NDLINO UNIT- C.F.M. <br /> VACUUM BREAKERB STOVE <br /> ROOF DMINB-R�INLEADERS MET�L FIqEPLAGE6 CHIMNEY <br /> _ BINK BERVICE-BAR ETC. WOODSTOVE/FIREPLACE IN9ERT <br /> �U�TOTAL �U�TOT�I � <br /> r[IIMIT � <br /> TOTl1l f[! . P[IIMIT � <br /> � T0TI1LFft � <br /> THIS POqTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> fllOqf�(TVSI{ A[Aq8Ef1'i1CN lIOEtETMCK M�NCNECKNUMBEN PUM�NFCNfEE <br /> iEE PECEIPtNO. <br /> U�[=d1l lCT I1RG <br /> V�CMiT011E It[� V11W1TION f!! <br /> ' CYEB ONO <br /> 7YPFOF�pNlT. OCCUP YOROUP NO.OFDWELlINOUNIiO <br /> lREOflIOG NO.OfOfORtE! M/AOCC.lW1D vUILDINO { <br /> PLUMBIN6 <br /> MECH�NIGL <br /> FIR PRINKlEN9 NEOUIR O YES O N <br /> OTHEN ��' <br /> M/�IC�TbM�CC.lY PUNlCNFLKEU�Y I1PpRFORIl6U�110EBY PENALTY <br /> TOTAL <br /> i <br />