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I� �'APPLICATION FG � cveretl <br /> I �Ire En�O��n C O N ST R U C 710 N 0 <br /> i everett PERMIT <br /> TO BE COMPLETED IN BLACK INK- PLEASE PRINT <br /> IBUILDING DEPT. <br /> � 259•8745 ❑ COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING ❑ SIGN <br /> CIiY ZI{' PIIONE � <br /> OWIIER MFIL ADOPE55 C� - ��a� <br /> ►.Eo (v1oSaA ��n� i-lovr uF tvc� �-;- �.Jr� 9SSa01 a�) �� � <br /> ARGMITEGiORDE5IGNER MeILADOFE55 <br /> c rv nr w�or�t <br /> CIiY 2�P PI�UiIf I�fV1Sf� <br /> MRIL PDORE55 E��'r•] <br /> GENEP�LCONiRPGiOR /� VAII DJ LL <br /> � . F�«�r1- �M 9kao4 d55 �23 <br /> � ,/_''t ,,` , 1 /__ . CiQ � f f_�rrlr h n�� (.t��--�� I i� o t. iicEr�sc• <br /> � �wll .fd—LYQISL9� MAIL�DORE55—r Lltt <br /> I MEGHNf11tAl CONTFACTOB <br /> z�r riw��e uc[ns[• <br /> I PLUMBINGCONTPACTOF <br /> una nooaess 01n <br /> CLA55OI WOPK <br /> NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOUDSTOVE/FRPL.INSER7 ❑ BUIL�ING RELOCATION <br /> VAWAl10N Of VIORK�COST OF M�TEA�A�S PLUS LP90F1 . <br /> Z <br /> DESCFiBE WOAK /� � � _ � <br /> � C��_ ' ' ^� � <br /> V �1 r C� ~ <br /> r <br /> i US[OFBUILDP�G I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- m <br /> � PLICATION AND KNOW THE SAML TO BE TRUE AND CORREGT.ALL <br /> I LEGAl0E5GRIPtIONOFPROGERTYISHOWNBELO�VONATUC�:�Ol1ACOPIESI pRW�R�WILOLBE OSrPNDOp��ITHWHEThOERSPECFIEDFEf7E � <br /> INORNOT.TfiEGRANTINGOFAPERMITDOESNOTPF7E-SUMETO � -r, <br /> �or_e�oc�.-oF GIVE AUTHORITY TO VIOLATE OR CANC[L THE PROVISIONS OF <br /> ' ANYOTFiERSTATEORLOCAILAWREGULATINGCONSiRUGTION ym <br /> �� OR THE PER�ORMANGE OF CONSTRUCTION. p <br /> 0 <br /> SiGNnt11R[OF GONiFPCLOR O�AUL�O�aZE��G[Ni ��tt T p <br /> f� <br /> � .�— X . � � _ / � C��� O � <br /> l � ��� :5 'ci� m <br /> �'. ' � � <br /> � <br /> � AFPI�CFNI' LllYliU5111E55UC[NSLNU � <br /> PROJEGTA�ORF55� I �,�r m <br /> � �� #�' EVi - �� � <br /> � w � MECHANICAL � � <br /> pLUMBING TYPE OF EOUIPMENT FEE <br /> TYPE OF FIXTUFE tEE ND• .--� (n <br /> NO. AIRCOND UNIiS-HP_EA < <br /> � WATERCLOSEL(TOILE qEFRIGLfiAIIONUNRS-HP. EA. — T <br /> n O D <br /> � BATHTUB BOILERS-H.flEA. �Q_�QQQ_LNC� <br /> I LAVAIORY�WASM BAS�N� GAS FlREO AC.UNITS-TONNAGF EA - — � m <br /> � SHOWER <br /> I FOi7CED AIR SYSTEMS-�.7L. M E�1 m N <br /> KITCHEN SINKd�ISP. y./��,L��EAt[�1S_BT.U. M p r <br /> DISHWASHER UNITIIEATERS=B.T.U. M1� <br /> 'I LAUNDRYTRAY - C N <br /> EyqPpR4TIVE GOOLERS - N <br /> CLOTNES WASHER CL0IHESORYERS m <br /> 7 n <br /> WATER HEATER VENTILATION FAN r <br /> ' m <br /> � URINAI_ RANGE MOOD - D <br /> DRINKING�OUNTAIN � <br /> AIR MANOLING UNIT- CF.M. � <br /> � FIOOR CRAIN STOVE _ <br /> D <br /> I VACUUM BRE/+KEfiS MErp�FiqEPI�CE 8 C��IMNEV Z <br /> � ROOF 7RAIN5-RAINLEADERS WOOOSTOVE/FlREPLACE INSERi � .--� <br /> I SINK�SERV�CE-BAR.ETC.1 -- _ <br /> N <br /> 0 <br /> � - -� <br /> . . SUO TOTAL 5 C� <br /> SUtiTOTAL pERM1T _ 5 ---- -- m <br /> ' � PERMIT s � S- '_ -'- <br /> . TOTAL PEE __. <br /> � TOTAIFEE S <br /> � THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> � — �•��„—,.;;,,-:,;�----- <br /> • � S�DE SEI�AGK nLaN cr�[cR NUMo!N <br /> FPONi5E18AGK REAfi5E10A�K (E[ "����N���� <br /> USEZONE LOi�PEA yACANT51iE FEES <br /> V�LU�TION FEE �" <br /> pY[5 ONO <br /> TYPEOGCONST. OCGUP�NCYGROUP NOOFOWELIINOUNIIS <br /> BUILDING S <br /> SIZE OF B106. NOAF STORiES MA%OGG.LOAD <br /> PLUM6ING <br /> MECHANICAL . _ <br /> FIRE SPRINKLEFS REOUIRED ❑VES 0 NO OT��ER - <br /> PENALIY <br /> PL�NSGMECKEOBY APPRFONISSU�NCEBY <br /> sPPL�G�iIOIUCC.BV TOTAL. -- --- <br /> I _--__.—"___ _---- ' <br /> � <br /> i <br />