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� <br /> � <br /> IA�EwrprNn A��'PLICATION FOR ������' everen <br /> CITYOF CONSTRUCTION e <br /> �- everett PERMIT <br /> TO BE COMPLETED IN BLACK INK— PLEASE PRINT <br /> BUILDING DEPT. <br /> 259-8745 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNE M�IL�OORE55 Cltt 21P PMON[ <br /> 2�-- 2� / �- ��< �7� �FD Z(� <br /> AR MITECTONDE51 ER MAILAy ORESS Cltt =IP PNON <br /> SG�t�,-C C� t�Gz�z.-� . i< �' ,�' 1 � <br /> OENERALCONTflRCTOF MAILAODRESS CITY 2ip PNONE LICENSEs <br /> MECIUNICALCONTRALTOq MAIL�DORESS Gltt ZIP PIIONE LICENSE• <br /> P�UMBINOCONTR�GTOR MAIL�ODRE55 Cltt ZIP f•IIONE 4CENSE• <br /> CL�SS OF WORN <br /> ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCATIUN <br /> VAI�OOff.O�FWOP�OF��`RIAL LUSUBORf� - � 7��A�� � _ <br /> �_�. <br /> DESGPIBE WORK p <br /> �--I <br /> .-� <br /> n <br /> USEOFBUILOINO I HEREBY CERTIFY THAT I HAVE flEAD AND EXAMINED THIS AP• m <br /> PLICAT�ON AND KNOW THE SAME TO BETRUEAND CORRECT.ALL <br /> LEO�LDESGRIPTIONGFPROPEBTV�S WNBELOW0f1ATT� nr�q�esi PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE '-""' <br /> OF WORK WILL BE COMPLETED WITH WHETHERSPECIFIED HERE• � � <br /> �or�.e�ocK�oF � INORNOT.THEGRANTINGOFAPEfiMITDOESNOTPRESUMETO y = <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS O� m <br /> ANYOTHERSTATEG9LOCALLAWREGULATINGCONSTRUCTION co <br /> OR THE PERFORMAN�•E�OF CONSTRUCTION. m o <br /> SIGNATUREOFCONTR 7-AtJTFiOR12EDAGENT DATE �C <br /> O 3 <br /> < � S -ZI <br /> VDJEC /R S -FPPUC� SGI B�5 SSLICENSENO. mrr <br /> O Z <br /> C <br /> PLUMBING MECHANICAL .r. ._. <br /> NO. TYPE OF FI%TURE FEE NO. TYPE OF E�UIPMENT FEE � N <br /> -G <br /> WATER CLOSET TOILE AIR CONO.UNITS-H.P.EA. T <br /> O A <br /> BATHTUB REfRIGERATION UNITS-H.P.EA. T n <br /> 3 <br /> LAVATORV WASH BASIN) BOILERS-H.P.EA. = m <br /> SHOWER GAS FIRED AC.UNITS-TONNAGE EA fn.-� <br /> KITCHEN SINK d DISP. FORCED AIR SYSTEMS-B.T.U. M EA. N <br /> v <br /> DISHWASHER WALL HEATERS-B.T.U. M n �j <br /> LAUNDRYTRAY UNITHEAIERS-B.T.U. M CN <br /> 3 v� <br /> CLOTHES WASHER EVAPORATIVECOOLERS m <br /> Z (7 <br /> WATER MEATER CLOTHES DRYERS -1 m <br /> URINAL VENTILATION FAN � <br /> DRINKING FOUNTAIN PANGE HOOD '� <br /> FLOOR DRAIN AIR HANDLING UNIT- GF.M. � <br /> S <br /> VACUUM 9REAKERS STOVE � n <br /> Z <br /> ROOF DRAINS-RAINLEADERS METAL FIREPLACE 8 CIiIMNEY � <br /> SINK SERVICE-BAR ETC. WOODSTOVE/FIREPLACEINSERT S <br /> N <br /> 2 <br /> O <br /> � <br /> .-� <br /> n <br /> SUB TOTAI SI/8 TOTAL s m <br /> PERMIT f PENMIT f <br /> TOTALFEE S TOTALFEE f <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> FRONTSETD�CN REARSEiBACK SIf.E5E104CK PLANCIIECKNUMBE(i PUNCH[CftFEE <br /> FEE �ECEIPiNO. <br /> USE20NE LOTAqE� VACANTSIiE <br /> OYES pN0 FEES V�LU�TION FEE <br /> ttPEOFCONST. OGfUPANCYGPOIIP NO.OFDWELLINGUNITS <br /> BUILDING S <br /> SIZE OF OL06. NO.Of STOIilES MR%.00G LO�D <br /> PLUMBING <br /> h1ECHANICAI <br /> FIRE SPRINKLERS REOUIRED ❑YES ❑ NO <br /> OTNER <br /> PENAI TV <br /> �PPUL�TIONACC.BY PL�NSCIIECKED�Y �PPRFOfl135UAHCE�Y <br /> TOTAL <br />