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� : <br /> �;►��'PLICATION FOfi� ��e«„ <br /> . ,".E".`°�" CQrNSTRUC'fION � <br /> CITY OF <br /> everett PERMIT <br /> TO BE COMPLETED IN BLACK INK— PLEASE PP.INT <br /> BUILDING DEPT. <br /> 259•8745 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNEfl M�ILADDFE55 CITY 21P �NONE <br /> Mog?ly 't',�� F�a�sT �9�J �vE'+eo,e&at� EvS�¢�7T <br /> �RCHIIEQOflDESIGNER M�ILAOOFE55 CITV 21P PHONE <br /> ,��N �pW,dlrAS �o /ar/fi4'l�AIK �L�DG �/E,e�lT Z g9'�sSb'7 <br /> OENEPdCONiPACTON M�ILAOORE58 CIIY ZIP PIIONE LICENSE• <br /> MECH�NIC�LCONiMCIOq MMLAOONE55 GITY 21P P110NE LICENSE• <br /> P�UMBINOCONTfl�GTOR M�ILFOONE55 dtt ZIP P110NE LICENSE• <br /> CU590F WOf1N <br /> � NEW ❑ ADDITION ❑ ALTERATION ❑ FEPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION <br /> V�L'J�TION ORK�COSTOFMATERIRLSPLUSI�BOR� <br /> �6a�0�0 . , <br /> OE.SCPItiE WOHK � � � ' � � <br /> 51i✓b�� �ic�/a F'FjAar& <br /> USEOFBUILOINO C I HEREB�CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> ��iGRiJS J G� PLIC/+TIUNANDKNOWTHESAMETOBETRUEANDCORRECLALL-� <br /> LE4ALOESCPIPTIONOFPHOPEHTYISIIOWNBELOWORATTACHFOIIRLOVIE51 PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> Q� I�� i .,�"� OFWORKWILLBECOMPLETEDWITHWHETHEFiSPECIFIEDHERE- <br /> �oY.�c�i.ocrc�or IN OR NOT.THE GRANTIPJG OF A PERMITDOES NOT PRESUME TO <br /> / � GIVE AUTHORITY TO V�OLATE OR CANCEL THE PROVISIONS O� <br /> ANY OTHER STATE OR LOCAL LAW REG ULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> � SIGNATUREOF / TORORAUiHOfiIZEUAGENT' DAiE <br /> G� - (�`2t�"� X / .frs/�wi� <br /> PPOJERFDDRE59 �PP AN YBUSIN ICENSENO. <br /> 5�03 �v� 6� �.lp — . <br /> .^LUMBIN� MECHANICAL � � � <br /> NO. TYPE OF FI%TUNE FEE NO. TYPE Of E0111PMENT �'' FEE <br /> WATER CLOSET TOILE AIR COND. UNI7S—H.P.EA <br /> BATHTUB ' REFRIGERA710N UNIiS—H.P.EA� '� <br /> LAYATORVIWASH BASI BOILERS—H.P.EA. .-_ <br /> � 9HOWER GAS FIRED AC.UNITS—TONNAGE EA <br /> NITCHEN S�NK6 DISP. FORCED AIR SVSTEMS—O.T.U. hl EA. O� <br /> DISHWASHER WALL HEATERS—B.7.U. M � ' _ <br /> LAUNUAYTRAY UNITHEATERS—B.T.U. M <br /> CLOTHES WASHER EVAPORA7IVE COOLERS _ <br /> WATER HEATEF CLOTHES ORVERS � — <br /> UFiINAL VENTILATION FAN _ <br /> ORINKINO FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN D AIF HANDLINO UNIT— C.F.M. <br /> YACUUM BREAKERS S70VE <br /> ROOF�RAINS—RAINLEADERS METAL FIREPLAGE 8 CHIMNEY <br /> SINK SERVICE—BAR,ETC. WOODSTOVE/FIREPLACE INSEfiT <br /> SUBTOTAL -O � Sl1BTOTAL S OC7 <br /> � - ' ' PEHMIT 3 PENMIT S <br /> i TOTALrEE 3 Q TOTALFEE S Z O <br /> THIS PORTION TO BE COMPLETEp BY BIJILDING DEPT. PERSONNEL <br /> fRONtSET R/C�K NEARSEIB CK SIDEISE'70 CN PLANGHECNNlIMOER PL�NCIIECKFE[ <br /> N�!-, � � K�a s '� �� �// FE�V� �S^ FEC(IPf^Oci l <br /> � � <br /> USEZONE /� �aTAAE� VACANTSIiE FEES VALUATION FEE <br /> �r•/ , , , DYES ONO <br /> TYPEOFCONST� OLCUPANCYGOOUP NO.OFOW�E1LLI`NOUNITS <br /> V—� � 2 I�/1 9ui�o�Ha • � : s (A�i�L'� ���j �'� <br /> . SIZE OF BLOO. ` � N0.OF STOPIE9 MpXALG LORO � '1 �O <br /> �7�/J s C ' /1 al PLUMBING v <br /> L � c.{.. � <br /> MECNANICAL L�� <br /> FIRE SPRINKLEFS FEOUIRED O VES ❑NO OTHER <br /> PENAITV <br /> APVLICpTION ACG.BY PIANS CHECKEO BY pPPR.FOR I55UANCE�Y �S Q l <br /> � TOTAL � V <br /> � :3� �-�1�1'1 <br />