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`�-APPLICATION F(,rt everen <br /> '".E"ro'"" CONSTRUCTION O <br /> un oF <br /> everett PERMIT <br /> TO BE COMPLETED IN BLACK INK— PIEASE PRINT <br /> BUILDING DEPT, <br /> 259•8745 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING � SIGN <br /> OWNER uea�oones5 cm zir P��ONE <br /> RCMIT�TEC_TO�tl�i/AA C' ��M�I�OD�E55 �~J �ry�4' �� _���Z Z� PHONE <br /> G�PLCONiqAC10R .M�ILaOD�[55 CI1V ,� Zi> PMONE �j� �1��%SE� <br /> ' / A <br /> /uE.�- .Q�C�' Siiw.� i.7/� Diy- "''� �T` E-�/v.-.c�`T` 9BFn/ �57-,00�o i6��R-� <br /> MECMANIC�LCO4TR�CTOq M�IL�DORE55 CItY ZIP iNONE LLEHSE <br /> PLUMFII�IOLONiPAGTOR IAAIL�DDPE55 GiiV IIP PHONE L�GENSE• <br /> GUSS OF WORK <br /> � NEW ❑ ADDITION L7 ALTEf7ATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDIIIG RELOCATION <br /> V�W�TION OF WORN�COST OF M�l ElII�LS PLUS LAOOPI <br /> G[.n ..� 2 <br /> U� O <br /> DESGRI9E WORK � <br /> v �C / r a�t7- iv�-rn �Y n, � <br /> m <br /> useoreuaqiNa I HEREBY CERI"IFY THAT 1 HAVE READ AND EXAMINED THIS AP• �� <br /> G�(�r�i� PLICATION AND KNOW THE SAME TO BE 7RUE A7JD CORRECT.ALL <br /> LEO�LDESCRIPI�ONOFPPOPEfViY1SNOWNOELOWORRTIGLMFOURCOPiES� PROVISIONSOFLAWSl1NDORDINANCES(BOVERNINGTHISTVPE �� <br /> —i "•l <br /> OFWORKWILLBECOMPLETEDWITHWHETHERSPECIFIEDNERE• � � <br /> �oi—eiocr�_oF IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHOfiITY TO VIOLATE OR CANCEL THE PFOVISIONS O� o m <br /> ANYOTH[RSTATEORLOCAILAWRE9ULATINGCONSTRUCTION cv <br /> �R THE PERFORMANCE OF CONS7FUCTION. m o <br /> :IIONATURE OF CONiR4GiOF OR AUTf10aIZE0 AGENi DAIE O 3 <br /> rn <br /> X� o� �iS�t/'S ^.� ..`. 7�"�j7 m—Zi <br /> PNOJEGt�ODRESS GPPUCAN:SCIIY BUSiNE55lIGENS[ND Q= <br /> �/.Z.5 ��L,�'.�, iGs� _.f /� �.20 � � <br /> VLUMBINO MECHANICAL - <br /> NO. TYPE OF FI%TURE FEE t10. TYPE OF EOUIPMENT FEE < � <br /> WATER CLOSET(IOILET) AIF COND. UNITS—HP.EA. O D <br /> BATHTUB REFPIGEPAIION UNI75—N.P.EA. <br /> LAVATONV WASH OASIN� _ �OILERS—H.P.EA � � <br /> S <br /> SHOWER _ GAS FlRED AC.UNITS—TONNAGE EA m ""' <br /> � <br /> KITCNEN SINH 8 DISP. _ FOaCEO AIR SVSTL1dS—B.T.LL M EA. — — O r, <br /> DISHWASHER _ WaLLHEAT[RS—B.i.U. M C� <br /> LAUNDRYTRFY UNI1 HEATEAS—B.T.U. b1 _ _ m Wl <br /> CIOTNES WASHER EVAnOf.ATN[COOLER9 = h <br /> WATER HEATER CIOTHESDRVERS ,i �� <br /> URINAL VENTILATION FAN � <br /> DRINNINC FOUNTAIII RANGE lIOOD _. � <br /> FLOOR OFAIN AIR HAHOLING UNIT— C.F.M. y2 <br /> VACUUM BREANERS STOVE -- ._ <br /> ROOF�RAINS—RAINLEADERS METAL PIREPLACE 8 CHIMNEV � <br /> SINK SERVICE—BAR,EiC. \YOOOSTOVE/FIREPLACEINSERT __ _ <br /> N <br /> —_ � _ 2 <br /> - O <br /> _ —i <br /> � <br /> n <br /> SUOTOTAL SUBTOTAL = . r� <br /> PERMIT S PERMIi S <br /> TOTALFEE S TOTALFEE 3 <br /> THIS PORTION TO BE COMPLETED 8Y BUILDING DEPT. PERSONNEL <br /> PRONi°FTB�CK AERRSETBRCN SIpE5E1BRCK PLhNCMECKMUMBER PUNGHEGItFEE <br /> fEE REGEIPfNO. <br /> USEZON[ �QTAA�p VACRN151TE FEES VALUATION FEE <br /> OYES ONO <br /> NPEOFCONST. OCCUOANCYGROUP NO.OFDWELLINOUNIfS <br /> BUILDIN6 S <br /> SIZE OF OlD6. NOAf S10RIES MAn.OCC.tOAD <br /> PLUM�INO <br /> M[CIIANICAL I <br /> FIRE SPRINKLERS REOUIRED ❑VES ❑ NO I <br /> OTIiER ; <br /> FENALTY . �, <br /> ♦PPLICATION�CC.BY PUN9CHEGN[OOY PVP0.FOPI5SWNGEtY <br /> � TOTAL i <br /> ��� SLG,IJ TO 'P�E A-l-�- 6� I <br /> � z �� �«�� �� i <br /> � <br /> _ ' <br />