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. ,_. <br /> ��`pPLICATION FO►.� _ �,N, <br /> �«'""" CONSTRUCTION <br /> everett PERMIT e <br /> ! BUILDIN�DEPARTMENT TO BE COMPLETED IN INK• PLEASE PRINT <br /> ; 269-8810 <br /> O DEMOLITION O COMBINATION O BUILDING O MECHANICAL �PLUMBING O 81ON <br /> � ��� MMl�DURE33 G�TY ZIP VMONE <br /> , -� Qi ti�_rn 0.'�z-�n�(�; rl - Iolols. {�le ���+1 `I���n?so`l -0?5' I lo • <br /> � MCMITECTq10El�OMER MULIIDDRES9 GTY 21P PNONE <br /> SICI.�rCYC_ ��Q��'1 <br /> pENEML GON1R�GlOR MML�DURE55 L TY 21P PHONE UCENSE <br /> ; � c��� a'�o� �-� � �a��.� �1�.;�a�- asa�s� <br /> ME �NIG�LCONi CTdI M�IL�DUMESS GIfY 2P PMONE LIGENSE <br /> �� M11LLApDRE55 ��TM ziP M�ONE �y�J IKENSE• <br /> KYIMIMOCONTIIACT011 �` I�.Xj��y' i <br /> i � �.1 �__ _ �.� .�y1h��;'j�� C.+� CC_�]uv�c� �i,�e �ia'f3'� ��lS 3_� ��2 <br /> � euusor K <br /> .� ❑ NEW �ADDITION ❑ ALTERATION ❑ REPAIN ❑ DEMOlIT10N ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDINO REIOCATION I <br /> Yl1l WT�ON O�MV�R I��T Oi M�fE�Pi�l4 PLU9^L11lORI (� � <br /> ; !7� �!i f\�) Qlr Y!"� Y-Q�7�1. �� Y]!=J � <br /> � DE�CIUBEwo11K I <br /> I <br /> : �u or waown 1 HEREBV CERTIFV THAT I HAVE READ AND EIUMINED THIS AR � <br /> � PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> ' PROVISIONS OF LAWS AND ORDINANCE9 QOVERNIN6 THIS TYPE <br /> � LEOnID[�CM►tIOMO�����T�'IeM�N�`OwO��TT11GHiWACOPIElI I <br /> ' c � T OFWORKWILLBECOMPLETEDWITFIWHETHER3PECIFIEDHERE• <br /> � �D��kp��bF ^ O INORNOT.THEGRANTINQOFAPERMITDOESNOTPRESUMETO <br /> GIVE Al1TMORITV TO VIOLATE OR CANCEL THE PROVISIONS OF' i <br /> ANYO"HERSTATEORLOCALLAWREpULATINOCONSTRUCTION � <br /> � OR THE PERFORMANCE OF CONSTRUCTION. . <br /> SION�TUREOFCONiNJ1CTORORAl1MOPIZEO�IiENT D�TE <br /> � �i <br /> 1 � � <br /> NqxCt�ODIIlp AMLICMIT!CIfYlUAMElb L10ENlE NO �, <br /> �(o ► t� �� ; <br /> Kuw��o MECMANICAL <br /> , ' <br /> ; No. Tt�[Of FlllTtlllt OR IT[M ru No. rrK or eoun�e�r na <br /> WI1TE11CL0lETITdLETI � IVC—AmNDLOUNIT9—M.P. <br /> ; � REFRIOEMTION IMRS—H.P.EA. <br /> �+ MMTIA <br /> IAVAtO11V�Wl1lM M16�N� BOILERS—B.t.U.M.P. <br /> �� OA9 fIPED 11.C.UNIiS—S.T.U. <br /> K��N���� — FORCED AIR 8Y9TEM!—E.T.U. M EA <br /> y dW�NAeMEII WALLNEATER9—B.T.U. M <br /> . u��TMY UNIT MEATER9—B.T.U. M <br /> CLOTN[f WAlMR EVAPORATIVE CAOlER3 <br /> �K CLOTNE9 DRYERS <br /> pMNKNq FOIJNTMN VENTIUi�ON FAN <br /> �10011 OIU1M ' � NANOE MO00 <br /> MCIQIOW MlVENTEM WI1iER MFATER <br /> 1100F OMIN6—MINLGDE118 WO00 STOVE <br /> lINK 1ldINCE—MR ETC.I METAL FIREPLACE�CHIMNEY <br /> flREPUCE INBERT <br /> MEATPUMP <br /> OA9 NPINO <br /> E%HAUSTFAN <br /> G <br /> S <br /> NM TOTAL t — M TOTK <br /> � �lMIIT f �T <br /> � TOTAL R! t TOt11L R! <br /> f110NTlF1��CR IIEMlEfMCK �IDElETNICK �NI:MECKNUMBEN � �����' <br /> U![20NE LOT�REA y�CANT3ITE FEES VALUATION �� <br /> OYES ONO <br /> BUILDIN6 : <br /> ttPEOFGONlT OCCIIP�NCVCROUP NOAFOWEILINOUNIf9 <br /> • PIUMBING <br /> 1 6RE OFlIDO NO OF STONIES M�x OCC.IOAU MECNANICAL <br /> 1 <br /> � OTHER <br /> FIRE SPRINKLERS REOUIRED ❑YES O NO STATE BUILDINO SURCMAR6E <br /> STATEENI:ROYSURCMARGE <br /> 1PPLIC�110N�CC BV PUN4 CHEGNFD BY �V7P.FOP ISSU�NCE BY �BLIC WC9K$ <br /> ' TOTAI <br /> PROPERN OWNERS ARE RESPON9IBLE FOR DETERMININO ALL <br /> PROPERrY LINE LOCATION9 AND REUiED EASEMENTB. <br /> t <br /> ,��n ,..._.. . . . . .. _ . . . _., , .. ... , _ , ... . <br />