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: <br /> ''�`�APPLICATION FC`�2 <br /> , '�.E"""'° CONSTRUCTION everett <br /> tirr of � <br /> everett PERMIT <br /> TO BE COMPLETED IN BLACK INK— PLEASE PRINT <br /> BUILDIN, DEPT. <br /> � 259-8745 ❑ COMBINATIUtJ ❑ BUILDING � MECHANICAL ❑ PLUMBING ❑ SIGN <br /> ��WNE MRILAODRE55 C}IV 21P PMONE <br /> .zf �✓cwC// /oo.�o r.,.r.,�s�-'�r /��as %t/l�'�'� >P��y 7%S-/�/S_�" <br /> >�CIIrtECTOROESIGNER MeII�OORESS GI1Y IIP (+uONE <br /> � GENEH�LLONTF.dCTOR A.41LRD�NE55 C��� 21P VHONE LiCENSE• <br /> wy <br /> MEC���NI[��CONiR�CIOH M�IlA00RE55 CITY IIP 1'IIVNf LICCNSi• <br /> AAA >P,�v,'cts PG B�x �137 �.v�t.71� W,f 9,Po��3 S�/7-s'%/.S �E/66D� <br /> �IUMBiNOGDNTRACTOR MAII�DOFE55 CItY 21P PtlONE UCEASE• <br /> L��SS OF HOAK�t <br /> ❑ NEW YJ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOL�TION ❑ WOODSiOVE/FRPL.INSEP.T ❑ BUILDING RELOCATION <br /> t4U� YJNO�WO�eILOSTOFM�TERIALSPLUSLABON� <br /> �/SOO� <br /> OFSCRiOF WO K /� / �' <br /> Z,� CL�� IO O/' � I� a.l I� l1�/7 �vD <br /> �sc or ouno� c <br /> �J�'$�avrr �1-� 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> /r PUCATIONANDKNOWTHESAMET08ETRUEANDCORRECT.ALL <br /> '.EG�L�ESCRi�iIONOFPROPERTY�SHOWNBclOWOR�T1�GNi0UNCOPIE51 PROVISIONSOFLAWSANDORDINANCESGOVEFiNINGTHISTYPE <br /> � OF WORK WILL BE COMPLETED WITH WHEiHER SPECIFIFD HERE- <br /> �or_e�oc�_or IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS O� <br /> ANY OiHER STATE OR�OCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. . <br /> SIGNATUpE OF LONtR�CTOR OIl�U71L7R12ED AGEN� D4tE <br /> . X ��/'_ L. �- ,���S <br /> '�OJECiA0DaE5v tPVUCPNPSCIIY ❑SINESSJUCF.NSENU <br /> �CL�C� q' I . NA. Sb . � it � 5���, �J�/ <br /> PLUMBING MECHANICAL _ __ <br /> � NO. TVPE OF FI%TUHE FEE NO. TYPE OF EOUIP'MENT FEE <br /> WATER CLOSET�TOILE7) AIR COND. UNITS—HP.EA. <br /> BATHTUB REFRIGEl7ATION UNI75—HP. EA. <br /> LAVATORYIWASHBASINI OOILEHS_I�IP. EA. '___'----' ___ <br /> � SI/OWER GAS FIRED AC UNI75—TONN�GE EA___ ___ _ <br /> KITCHEN SINK 8 DISB FOl10ED AIR SY5IEMS—flT.U. M EA. <br /> DISHWASHER WALLHEATERS—B.T.U. M <br /> LAUNOFYTRAY UNITh1EATERS—U.T.U. M <br /> CLOTHES WASHER EVAPORATWECOOLERS _ <br /> WAiER HEATEF CLOfHES ORYERS _ <br /> URINAL VENTILATION FqN <br /> DRINKING FOUNTAIN A/+NGE HOO� _ 11 5 O <br /> FLOOR OFAIN AIR HANDLING UNIT— QF.M __ <br /> VACUUMBREAKERS S�OVE ___ ____ ____ _. __.___ <br /> POO�DFAINS—RAINLEADERS _ METALIIREP�ACE8C111MNEV____._ _ _ ____ __ <br /> SMK�SERVICE—OAR,EiC.) PJOODSTOVE/FIREPLACEINSERi _ __ ___ . <br /> _—_ — _ L 1r�� ._' i'.. '. __ _�.__ � . <br /> --�- –�=--=-------- -- -- <br /> - — -- – ------ - ------ — <br /> SUBTOTAL _ _" ______'___'_SUBiOTAL"_'""__ _. f _'_""' __ ___ <br /> PERMIT S PERMIT _ _ _ S ___ /[2 <br /> . — _' ' ' ' _ o , <br /> TOTALFEE SI TOTALFEE S <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> �RGNiSETBACN REARSET9AGK SipESEiBACN PLnNG�CCRNUMHER VIAt�W�ECNfFE <br /> r�e necEirr rvo <br /> USE2DNE LOTARE� WC�NiSRE <br /> ❑YCS ONO FEE$ VRWATION FEE .. <br /> � hpEOFCONSf OCCOP�NLYGROIJP NOAFDWELL�NGUNIIg <br /> BUILOING f � <br /> giLE O�BLOG NO.OF SiDRiES M,1Y.00C IO�D — — — <br /> GWMBING <br /> MEG��ANICAI <br /> FIRE SPP.INKLERS REOUIREO ❑ VES ❑ NO — - — <br /> L - o��E� <br /> PENfLTY <br /> ♦PpLIGT10N�CC OY VLANSC6;GMEOBY �PPq FORISSWNCEBY --- — --- --- <br /> TOTAL <br />