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� <br /> �;PPLICATION FO��. ��«<n <br /> ,"'E"'°'"" CONSTRUCTION � <br /> Wtt OF <br /> everett PERMIT <br /> TO BE COMPLETE� IN BLACK INK—PLEASE PRINT �, <br /> BUILDING DEPT. <br /> 259•8745 ❑ COMBINATION ❑ BUILDIN�;: ❑ MECHANICAL ❑ PLUMBlNG ❑ SIGN <br /> �NEp MGILA�DFESS GIiV 21P VNONE � <br /> �12. L=VeYcTt ��C_Kc�7t .S)9 LOI,"Z`� C✓'ETI�Tt? �IE�9O/ ..�S,a— J.� 4/ <br /> �PGNITEGiON0E51GNEN M�ILAJORE55 Cltt 21P P110NE <br /> ,�— . <br /> l <br /> GENER�LCONTR�G70P AIAILAD�RE54 Gltt ZIP PMONE IIGENSE• / <br /> �p� e�c.� Ncs G—C . � � �ox � S� Mfk�"svicc� �1Ft7o Gs'3- � �L3 �wic�ie�c <br /> MECH�NIGL CONTfl�CiOq MAIL�ODHESS <br /> CIiV ZIP PMONE LIGENSE <br /> VlUM91NGCONTR�GTOR MMLAD�RESS GTY 21P PHONE IICEHSE• <br /> CCv1FCS'��u,�{� �� � � ZL'~Ave SL ��TNC�c 96EI2 3�S•( C14 GRhFT1��L�l�U <br /> GL�SS Oi WOFN <br /> ❑ NEW ❑ ADDIT:ON � ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOC�TION <br /> WLWTION OL WORN�CAS7 OF M�TENu�S VW5 LABOIp <br /> ..?3 ' Co��� <br /> DESCRIBE\YO <br /> l.�f - 1 � �FUV�Mt/�tf � <br /> useor ew�ov+e I HEREBY CERTIFY THAT I HAVE READ AND E7CAMINED THIS AP• <br /> ��—G�,,� — ��— I—F�C� PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL <br /> tEO�L�ESCPIPTIONOFPROPENTY�SNOWNBEIOWOflITT�CNFOUHGOPIEA PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEfiE- <br /> iot_e�ocx.__aF IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> ANYO HTERST'ATEOR OCALLAWREGULATINGCONSTR�CTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIGNATURE OF CONTR,ICTOR OR AUTHOR12ED AGENT DATE <br /> - X ° � 3- /9- 8G <br /> APPL'GANiSQTY 51 Sl6EN5Et10. <br /> PflOJEQ�LORE55 <br /> .a,.�a c�� � A ��> �.-��T�-rr <br /> MECNANICIIL <br /> PLUMBIN6 7YpE OF EOUIPMENT FEE <br /> Np, TYPE OF FIXNNE FEE NO. <br /> � WATERCLOSET�7011ET) C� AIRCUnD.UNITS–H.P.EA. <br /> REFRIGERATION UNITS–H,P.E�. <br /> BATNTUB <br /> UV�7'OHY�WASN BASIN) BOILERS–H.P.E�. <br /> GAS FIRED AC.UNITS–TONNA6E E0. <br /> SHOWER <br /> KIICHEN SINK 8 OISP. FORCED AIR SYSTEMS–B.T.U. M . <br /> WALLHEATEFS–BLU. M <br /> UISHWASIIEH <br /> UNITHEATERS–BT.U. M <br /> L�UN�FVTRAY <br /> CLOTHES WASHER EVAPORATIVECOO�ERS <br /> CLOTHES OHYERS <br /> WATEH NEATER <br /> \'ENTILATION FAN <br /> UflINAL <br /> DRINNINO FOUNTAIN RANGE f100D <br /> FIR HP!IDLINO UNIT– C.F.M. <br /> FLOOR DRAIN <br /> V�CUl1M BREAKERS STOVE <br /> ROOi ORAINS–R�INIEADEFS MEiAL FIflEPIACE 8 CHIMNEY <br /> SINN SERVICE–BAR.ETC. - W�ODSTOJE/FlFEPUCE INSERT <br /> BUB TOTAL � <br /> 8UB TOT11L <br /> PERMIT { PERMIT � � <br /> TOTALFEE f B TO7ALFEE f <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> PL�N CHECK NUMOER PvUN GNECR�EE <br /> LflONT SEiB�CK REAP SETBAGK SIDE 9ETB�CN Q) pECEIPT NO. b P5f3 <br /> �•� �� ��a�G FEE / �� !O <br /> IlSE 20NE LOT�REA VAG�NT SITE FEEB V�LU�TION FEE <br /> Q��J , a,A �YES �/� <br /> 1� 7 <br /> ttPEOFCONSt. OGLUPANLYGROUP NO.OF�WELlIN011N1T5 -- <br /> �N f?j.2 O euaoiNa s237L�.+•Oti <br /> 512E Of OLOG NOAF Si0RIE5 µ�K'��c'`��� p�pMBING • O w <br /> ��� �� � '�T <br /> MECHANIC�L `� � <br /> FIRE SPRINKLERS HEOUIRED ❑YES NO oiHER <br /> PENAL(Y <br /> �PPLIG�TIDN�CC BY PL�NS CNEGNEU BY �PPfl.FOfl 15911�NLE BY / 9 2 5� <br /> TOTAL <br /> M.M. Jf�F�. L •G <br />