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��HPPLICATION FOIt <br /> 1 !V!f!M <br /> '^.Ew,°,.." CONSTRUCTION � <br /> cm oF <br /> everett PERMIT <br /> TO BE COMPLETED IN BLACK INK— PLEASE PRINT <br /> BUILDINQ DEPT. . <br /> 25�•8745 � ��yf_ O�ABIkA�ON� , � BUILDINO ❑ MECHANICAL ❑ PLUMBINCi SION <br /> l ZIP PNONE <br /> M�IL AODRE59 ��TM <br /> � 1 I <br /> OWNER . . . ;, ( / . <br /> i , � ` � I . ' . . � ' 1 (. �. � �, � � � � �1 ' I.,\' '�.' <br /> ♦qCN11ECTO0DE9�ONER MNL�DORESS <br /> � citt � mp rHONe <br /> OENEN�LGONTIUCTOR M�I�AODPE93 <br /> Cltt ZIP PIIONE LICENSE• <br /> ��n, Z�p �IIONE LICENSE• <br /> MECH�NIC�LCONtMC�Oq MMLAOOBE99 , <br /> ��n, Z�p PHONE LICENSE• <br /> FWMliNOCCNiRAC10R M�IL�OCPE99 <br /> CLASS OF WORN <br /> ❑ NEW O ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ N�OODSTOVE/FRPL.INSERT BUILDIN6 RELOCATION <br /> W W�IION OF WOIiN�WST OF MAICRULS PWS L�00N <br /> � 1 <br /> OElCRIBE WORK � � <br /> . � f�. <br /> � ( .1 r � . � <br /> USEOFBUIlOINO � I HEREBY CERTIFY THAT I HAVE READ AND E%AMINEO THIS AP- <br /> ( ��� �. t �• i I�� PUCATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL <br /> IEO�LDE5C111PT10NOFPHOPEII�YIS�lOWNBELOWOA�tT�GHFOURC0VIE5) OFWORKWILOLBECOMPLE EDDWITHWHET�HERSPECFIEDHERE- <br /> Loi__B�o��_oF IN OR NOT.THE GRANTINQ OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIONANRE OF CONTflACTOP OR AUTHORIiED A�ENT DA7E <br /> 1 A / 1 .� .', r 1 �i � . � <br /> �•..� ' 11 � 1 _ ' f l (i �� 1 l /`� � i ' f�. i � � � � .. <br /> , -� � �pPLIG�NTSGITY8U51NE55LICEN3 NO. <br /> iR0.1EC1ADORE55 /� <br /> O V � � — <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FI%TUNE <br /> FEE NO. TYPE OF EOUIPMENT FEE <br /> AIR CONO.UNIiS—H.P.EA <br /> WATER CLOSET 1iOILETI <br /> REFRIGERATION UNITS—H.P.EA <br /> B�iHTUB 601LER5—Ii.P.E0. <br /> �pypTppy�WASH BASIN� <br /> GAS FIRED AC.UNITS—TONNAGE EA <br /> SHOWER <br /> FORCED A�H SYSTEMS—B.T.U. M EA. <br /> KI7CHEN SINKB DISP. <br /> WAIL HEATERS—B.T.U. M <br /> OISNWASHER <br /> UNIT HEATERS—B.T.U. M <br /> LAUNDRYTRAY <br /> EVPPORATIVE COOLERS <br /> CLOTHES WASHER CLGTHES DRVERS <br /> WIITER HEATER <br /> VENTILATION FAN <br /> UFINRL qANGE HOOD <br /> ORINKING FOUNTAIN _ <br /> AIR HANOLING UNIT— C.F.M. <br /> FLOOR DRAIN SiOVE <br /> VACUUM 9REAKERS <br /> ROOF DRAINS—RA�NLEIIDERS METAL FIREPLACE 6 CNIMNEY <br /> WOODSTOVE/FIREPLACEINSERT <br /> SINK SERViLE—BAR,ETG. — <br /> $UB TOTAL s <br /> SUO TOTAL — pERMIT s <br /> PE�MIT � s <br /> TOTAIFEE 3 TOTRLFEE <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> i4RN CHECk NUMOEIt 1`UN GIIECR f EE <br /> f110Nt5El0�GN ncnnscmn SIDESEIU4GK pECEIPiNO. <br /> � __ �,n FEE <br /> 4J <br /> lISEZONE IOfRREA yqCRNI51iE FEES VALIIFTION FEE <br /> �/�: ures qS+o <br /> ttPE Oi CON�^rT. OCCUPAtlCY GROUP NO.OF OWELL1�NITS - � <br /> /�/ � —� s � ODO — <br /> .� f� OUILDINO <br /> S12E OF BLDO ��O Of S10nIE9 M�%.OGC.LO�O <br /> � / ��__ PLUMBING <br /> i <br /> MECHANICAL <br /> FIRE SPRINKIERS REOUIRED ❑ YES NO oT11ER <br /> PENRLTV <br /> �APLICRiION ACG OY PL�NS CIIECKED BY RPPO.FOR ISSUANGE BY TOTpL <br /> ��y <br /> , . . . <br />