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�APPLICATION F(> �t <br /> '"""'°`"" CONSTRUCTION QYe1M <br /> CIPI OF <br /> everett PERMIT <br /> BUILDING DEPARTMENT <br /> 259•8745 TO BE COMPLETED IN INK• PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDIN(i ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWIIER n � M11LAD�RE9Sn Cltt 2�P PHONE <br /> �l�li�,-„ t�� U\�r� (_,G,OZ l �b�n ._��a` �. �.l�evP�� `ISG��3 ���� �3�� �h <br /> •RCNIIEQOROE910NEN �ILApORE55 LITY ZIP PIIOHE ' <br /> 6ENER�ICONfPAGfOR M�IL�UORESS CIIY ZIP PI�ONE IIGCNSE• <br /> MECNIN�C�LCONtOAGfOq M�IL�OOPE55 C�IY EIP PIIONE IICC�u[• <br /> PLUMBiNfIGONIR�CfOR M�IL�ODRE59 CITY ZIP GIIONE tiC[NSE• <br /> C1�S50f WORIc <br /> � ❑ NEW � ADDIiION ❑ ALTERATION Q REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION <br /> wiu�n NO�WORM�COSIOIM�I[PULSPWSLABOPo <br /> '1�� �',�I��� , O� <br /> ocscn�ocwonK � <br /> c���r� �c�,��rZ������ -�-n .�'�a u � � frF�►�T j ;. <br /> use or emio�No <br /> I HEREBY CER IFY THAT I HAVE READ A D EXAMINED THIS AP• <br /> PLICATIONAN ,KNOWTHESAMETOBETRUEANDCORRECT.ALL <br /> LE6�L�ESCRiP110NOfPppPFJI1Y�510WNBELOWOR• cNrou GOPIESI PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> �r/ � �J -{. � � '� OFWORKWILLBECOMPLETEDWITHWHETHERSPECIFIEDHERE- <br /> �oi�� n eioc�LG.tor IN OR NOT.Tl1E GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> � � - GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> l �� C ' u-�`11\ r � lOYC ' P ANYOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. � <br /> `�— � � �I SIGNA RE OF CONTHACTOR OIl AUTH IZED�GENT OA1E— � � <br /> � � c� / IS �JS <br /> }fe r>��\� j�F�l l�u I`,, ' J' - `F1 S'��wL ti� <br /> FBOJECT�DORE55 en �+.pjp\rr( `•�PP��CANI'SGIIY6USMESSLICENSENO <br /> �c{:�`Z �� � � <br /> o�"�iv,,, c;��\ �ve �ve� <br /> PLUMBINQ MECHANICAL <br /> NO. TYPE OF FUfTURE FEE N0. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET�TOILET) AIR COND.UNITS-N.R EA. <br /> B�TMTUB REFflIGEPATION UNITS-H.P.EA. <br /> LAVATORY�WASH BASIN� BOILERS-H.P.EA. <br /> $HOWER GAS FIRED AC.UNITS-TONNAGE EA <br /> KITCHEN SINK 8 D�SP. �ORCED AIR SVSTEMS-B.T.U. M EA. <br /> DISHWASHER WALL HEAIERS-B.T.U. M <br /> IAUNDi1V TRAY UNIT HEATERS-B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLEf15 <br /> WATER HEATER CLOTHES DAYEFS <br /> URINAI VENTILATION FAN <br /> DRINN�N(3 FOUNTAIN RANGE HOOD <br /> FLOOR ORAIN AIR HANDLING UNIT- C.F.M. <br /> VACUUM BREANERS STOVE <br /> ROOF DMINS-RAINLEAOERS METAL FIREPLACE 8 CHIMNEY <br /> $INK�SERVICE-BAR.ETC. W'JODSTOVE/FIREPLACEINSERT <br /> SUB TOTAL SUB TOTAL f <br /> PERMIT 3 PERMIT S <br /> TOTALFEE f TOTALFEE S <br /> THIS POHTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> fRUNISEtOSCfl IIEeRSE`IB�`CK SIOESETBACR P��NCRECKN MOER PUNp1ECnfEE <br /> � � � �y�/ � � / C� � �D�� fEE ?S�� fIELCiPf NO ��.J�� <br /> USEION[ � l01 BAV O ', oC <br /> ^ N�C�N !E FEES WILUATION REE <br /> �.�" OYES O /'' <br /> tYPEOfCONS OCCIIPIINGYGf10UP NO.OFOWELLINOUNITS 7G <br /> U P n <br /> SIIEOfBl'�^6 NOOf5I0RIE9J M�ROCGIOAD BUILOINO S�i)�lJ� �f� J[�- � <br /> � (��,/ Sr� � PLUMOING <br /> MECNANIC4L <br /> FIRE SPRINKIERS fiEOU�RED ❑ YES ❑ NO <br /> OTIIER <br /> PENRLTY <br /> R'PL�C�IIONACf. BY PLANSCIIELNEOBY APPO.f0111SSU�HCEOY -- <br /> ^ � - � TOT�L <br /> � �� — _ <br />