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� <br /> �;�.E�ro� �`�APPLICr�..TION Ft;��R � e�e�e„ <br /> s�TM°F CONSTRUCT�ON <br /> everett PERMIT e <br /> TO 8[COMPLETEO IN BLACK INK— P�EASE PFiINT <br /> BUIIDING DEPT. <br /> r 259•6745 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMOING ❑ SIGN <br /> OWIIER M�ILApONE55 Cltt dP VI�ONE <br /> ��Rco r.�a. /o �oz ..�_ ;� '-'"�/..��'N �%'��'lA,�1>> 9flao,' �z7_o�6 <br /> •PGHIIECTORDESIONER //ML�OpRE55 Cltt IIP PNONE � <br /> G[N[RILCONfP�qOR MMLApDRESS LItV LiV PHONE LICENSE• <br /> ' IJ,G ,GJao r� �o %ox /6 %G b�d2tiJ 9�9-3/�'� "r <br /> MECHANIC�LCONTRACTOq M�ILI�pORESS CPY ZIP PMONE 4CENSE• <br /> PLIIMBINOCONiMLTOR MML�ODPE55 CifV ZiP PHONE IiCENSE� <br /> !:V.SSOF WONN <br /> C� NEW ❑ ADDRION ❑ ALTERATION ❑ REPAIR � DEMOLRION ❑ WOODS�OVE/FRPL.�NSERT ❑ Ol11LDING RELOC:�T�ON <br /> /+W�nON OF WORN ICOST OF M�iERULS PWS L�80�I <br /> i�f.SCniBE wOAK <br /> %�emo oF F�X��S'T'n. ,b�Lc� . <br /> ��Sf p�9WLUir1G <br /> � � I FIEi7E8Y C[F711FY iFIAT I HAVE R[AD AND EXAMINED TI-IIS AP• <br /> �-'-/H��- PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL <br /> LEp��DE9CRIP710NOFPROYERTY�5H0\YNBELOWOR�TiRGNFOURCOPIES� PROVt510NSOFLAINSANDORDINANCESGOVERNINGTHISTYPE <br /> OF WORK WILL BE COMPLETED WITH WHETHEiiSF'ECIFIED HERE- <br /> �or,e�oc�_ov IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE P.U7HORITY TO VIOLATE OR CANCEL THE PROVISIONS O� <br /> I S' ��J � ANYOTHEF STATE OR LOCAL L�W REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> A7"r�C�Lo1j sicNnrur�eorcoN�RACTORORAUf110PiZEDAGEN! DA7E <br /> J O 6 / �j/ Cj K x i L�. ,E�X � J ZJ d 'y <br /> PAOJEf.7�00RE5S •PPLI NiSCIIYBU51NE55UG EN <br /> PIUMBING MECHANICAI <br /> NO. TYPE OF PI%TURE FEE NO. TYPE OF EOUIPMENT �� FEE <br /> ... __ _ '_--_ _ _._ _ " . '__" -_'__ — <br /> _ WatEF CLOSET�TOILETI nIR COND. UN175-H P EA. ____ ___ _ _____ _ _ _ <br /> _ BAINTUB HEPfa(,1 MfION UtLTS H P En _ _ <br /> LAVATORY�WASH BASIN� BOILEPS-kIP. EA <br /> SHOWER GAS FIRED A.C. UNITS-TONNAGE Eh � <br /> KITCHcN S�NY,6 LISP. FORC[D AIR SYSTEMS-B.T.U. M EA <br /> D154WASHEH WALLHEATERS-B.T.U. M <br /> LAUNDRVTRAV UNITHEATERS-9.T.U. h7 <br /> CLOTHES WASHEq EVAPCMTIVE COOLERS <br /> ' WATER HEATER CIOiMES DRYFRS <br /> 11RINAL VENiILAiION FAN <br /> ORINKING FOUN7AIN RAN�E I100D <br /> FIOOR ORAIN —}- AIP HANDLING UNIT-_C F M______ _ ____ _ <br /> VACUUM BREANERS F STOVE _____ _ _ _______ <br /> ' — _'— __ .... . <br /> ROOF DRAINS-flAINLEADERS ___�_ MEIAL I IREPLA�_8 Ch11MNEV____ ___ _____ __ <br /> SINK 6ERVICE-BAR,ETC WOOOS�OVNiIREPLACEINSER� <br /> _ _ ___'.__'_"-__ "'_'___' _ . '_.__ __ '_' __ <br /> SUBTOTAL SUBTOTAL 5 <br /> - _ _'._"'._____. . ."'-—____-_'_'_ . __. _ _ _ _"__'_ _ <br /> PERM!T f PEfIM1T 5 <br /> TOTALFEE f TOTALFEE 5 i <br /> THIS PORTION TO BE COMP�ETED BY BUILDING DEPT. PFRSONNEL <br /> fqONISEIB�GK qEARSETB�GN SIpE5El8�CN ?LNNC��[CnNW.iO[R �IANr,q��r.r[F <br /> rEr iveCcmn;u <br /> U3[20HE LOT�REA y�G�NiS�f[ ---- �-- � ' <br /> IlYES 1]HO FEES _VR�U�TION FEE , e <br /> 1vPE0fCON5C OGCU�RNpYG�OlII' 110.Oi�WELLIN0UN119 � <br /> DUILOING ___"___"-_ "S""--"— _— - <br /> 92EOf8LDG NOO�SLORiES MAR.UCCLOnD ----�---�--- ---------- --- - � <br /> PWbtURlG _' -' _— — . <br /> — - — AIEC4UNIC/•l — '-----' ' <br /> FIRE SPRINHLERS REOUIRED ❑ YES ❑ NO �-----'-'-- — --��- — � <br /> L orHer --'------ --- <br /> PENALiY <br /> �PPLIWTION�CC.BY PUNSCNEGKEDOY APPq.iUNiSSUANCEUY <br /> TOTAL <br /> r"� <br /> T <br />