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��?PLICATION FO�.-' �,�,�„ <br /> IMEwrprN^ CONSTRUCTION 0 <br /> �,n o, <br /> everett PERMIT <br /> BUILDING DEPARTMENT <br /> 259-e�45 TO BE COMPLETED IN INK• PLEASE PRINT <br /> �[bEMOLITION ❑ COMAINATION D�'BUILDINO O MECHANICAI. O PLUMBINO ❑SION <br /> pWHEP MeII�DOHE35 CIIY iiP vNONE <br /> ��_., .•-.•, �,��� ,rr� �IG �� SsflNURS'r AVE �vE�ttr� ��f5io� ,rsti•�'�1 <br /> �C l rv .�� 1 1 <br /> �RLMIIFCIOROE614NER Me11�00RE9B CItY iIF P ON[ <br /> Tmoiz�����aJ Dr- s►� �zL� •rw�K•,o,� Evea�rr �ft3zo.s 3;s- 31a0 <br /> OENFR�I CONIP�CtUR — M�IL�OURE!! ' C�1Y iIP PIION[ IICLM <br /> _ ���R � S <br /> MELNINIQL CONtR�C10� M�iL�0011ElD CITI bP PNONE UCENlF• <br /> PWMliNOCONIR�CION MUL��ORE!! CIfY IiP Fi�ONE LKENSE• <br /> CU! Of WOAN <br /> �NEW ❑ AODITION ❑ i LTEHATION ❑ 11EPAIP ❑ DEMOLITION ❑ WOODSTOVE/FRPI.INSERT ❑ BUILDINO RELOCATION <br /> V4U�IION Of W011N IL�f Me�Clll�l9 YL�pl� <br /> 8V <br /> DFSC111EE 11M <br /> .D�P��x <br /> USE O�BUIl0�H0 � :IEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS AP• <br /> QcniTq �- PLICATIONANDKNOWTNESAMETOBETRUEAN�CORRECT.ALL <br /> y��e�cRIP710NO�tROPEPIY�9NOWNBF.IOWOR�T�T�CNiWl1 OPIE9� PROVISIONSOFLAWSANOORDINANCESOOVERNINOTHISTVPE <br /> 1 '',IIr,, OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br /> �p1�e�oc` yY�nr �-r� � INORNOT.THEORANTINOOFAPERMITDOESNOTPRESUMETO <br /> 61VE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANV OTHER STATE OR LQCAL LAW REOULATINO CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> B�ON OFCONI fOR RAUTNORI2EU�OENf O�TE <br /> _. � 2� 1�^�! / <br /> �� � <br /> pp � �PP4C� HCIfYBUSINE85LICEN9EN0 <br /> N� <br /> PIUMSINO MECM�NICAI <br /> Np, T�iE OF f11ITUPE FE! NO. 7YPE OF EOUIPMENT FEE <br /> WATERCLOSETTOIIE B 111RCOND,UNIT3-M.P.EA _ <br /> L B�TNiUB REFRIQER�TION UNIi9-N.P.E�. <br /> 7� LAVATOPY WASH BASINI BOILERS-H.P.Eti <br /> SHOM�EH WS FIRED AC.UNITS-70NNAOE EA <br /> 1 KITCHEN 91NN 6 DISP. FORCED AIR SY3TEM9-B.i.U. M E�. <br /> 01SHW�SHER WALL HEATERS-B.T.U. M _ <br /> IAUNDRVTRAV UNITIIEATEBS-B.T.U. M <br /> Y CIOTHES WASMER EVAPORATIVECOOLERB <br /> W�TER HE�TER CLOTNE90RYER5 � <br /> UNINAL VENTIL�TION FAN /��'j <br /> DHINKINO FOUNiAIN R�NOE HOOD �G� <br /> FLOOR OHAIN AIR HANDLINO UNIT- C.F.M. _ <br /> V�CUUM BREAKERS STOVE <br /> ROOF ORAINS-R�INLEAOER9 MET�L FIREPUCE 6 CHIMNEV _ <br /> SINN 19ERVICE-BAR,ETC. WOODSTOVE/FIREPLACE INSEAT j_ � <br /> —1- <br /> BUBTOTAI BUBTOTAL � __ � <br /> PERMIT � PEFMIT � _ <br /> TOTIIL FEE • 70TAL FEE � _� <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> �AONt9EIB�C� nE�NSEq�B�GM 91DE9EfB�C`R PL�NCHEC NUMBER / I ' �UNCI�ECKiFE ^ <br /> �/1 .f�O ✓ $� � I� 1 V� fEEOt U 1 � PELEIPtN003S� 'J II <br /> O <br /> USE20N� �Ot��E� y�C�NT9rtE �!!■ V�LU�t10N F[f <br /> � 2 ni� OYE9 aN0 <br /> C <br /> h'PEO�CONlf' 1 OCCUP.1NCYf.000P NOD�OWIE�LLINOUNIt! r'� C� <br /> �� N � � � r BNLOINO ��` � <br /> SKE Of BI00 NO O�g10PlC! M�M OCC.IO�D <br /> ��� � �� ��/'' — I � PLUMBINO _ <br /> � MECN�NIC�L �{ �„/ <br /> fIRE SPFlINNLEFS REOUIRID "J VES O NO / � � <br /> OTNER <br /> PEN�LTY �• a <br /> ���UC��ION�CGBv f'L�NSCtlECMEDBV �PPRiOf1139U�NCEBY M�..,�, <br /> � �� TOTAL _ � <br /> L •� <br />