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` .,,,,,�,,,, � ,�, .�:APPLiCAT10N FC�R �,�„ <br /> �^M .� CONSTRUCTION <br /> everett � � � � � :� � PERMIT e <br /> BUIlDINO DEPT. T�BE COMPLETED IN BLACK INK—PLEA8E PRINT <br /> ��746 ❑ COMSINATION ❑ BUIIDING ❑ MECHANICAL ❑ PWMBINO ❑ llpN <br /> owwI� ►w��oonea un ar v�ron¢ <br /> lf�� i C��♦ /?')i l /��l . ��C�n � ��1 P'b�w ��.�1 :i L'��/�� /-,/�-_� /'��) <br /> .z�n�cra�waoMe� �oo�ea un ar �� <br /> ��C�t�T� / // MNL/� CIIY SIP <br /> f I 1� li•-�' 1 1 . �>(J� � / / / � PHONE IICEM[� <br /> ;lf�lll._I� V . r L �.9 � i )!')�r��� -�- jT L(li) ^r// �� {��/'ii�i��� ia41Y ''• '�'ll:�;�t <br /> �M��CkC�MCi011 MNL�ODMN p� .LP ryqNE LIOEMN• <br /> KIIIAMOWNTMCTOII MIIILA00110/ q1Y LP PIqNE IK.ENlE• <br /> CUM OF 11011R <br /> O NEW LY� ADDITION O AITEMTION ❑ REPAIR ❑ DEMOLITION ❑ WOOD9TOVEIFRPLINSERT ❑ BUILDINp REIpCATION <br /> MILWLDN�p�/'N7'0110.1CdTOF WttMK�KII�lM7q <br /> ,•/U �l7�� <br /> OtlCM[q0111t <br /> --�> Q / <br /> L)�t�a,� !`C�C i 1.17 ? <br /> IM[pMlRDltq <br /> r:;;� '�� � �-��` � � �)�t.=� 1 I HEREBYCERTIFYTHAT I HAVE READ AND EXAMINED TMI9AP <br /> P_ICATION AND KNOW THE 9AME TO BE TRUE AND CORRECT.ALL <br /> ual0l�dAt�M1OF�IW►lIITVIINOWNKtOWO11ATf11CNFWIICOME4 PROVISIONSOFLAWSANDORDINANCES60VERNINOTH!STVPE <br /> OF WORK NALL BE COMPLETED WITH WHETHER SPECIFIED HERE <br /> �°T_K°��—°F IN Oii NOT.THE ORANiINO OF A PERMIT DOE3 NOT PRE9UME TO <br /> OIVE AUTNORITY TO VIOLATE OR CANCEL THE PROV1310N3 OK <br /> � ANY OTHER STATE OR LOCAL LAW REOULATINQ CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> &ONAiUNEOFCONTI� ORORAUTHQRIZEDAOENT D�iE��/�I��fI.I'���:' <br /> � � � ,� �. <br /> �( /i•� � <br /> "7� �:M1'1' ' {ll_ � � .•�.y��-� <br /> /IqJECT 110011[M A APVLICIW I'!CITYlU61NE&1 LICENSE NO. <br /> Q C <br /> �M��M� MECMANICAL <br /> MG• TT[Of FIXIUII� FE[ NO. TYP[OF EOUIPMlNT fEE <br /> WAiER C!09ET TqIE AIR COND.UNITS-H.P.EA <br /> dITM1U! pEFPoOEMT10N UNIT9-N.P.EA <br /> tAVATOqY WA9H B1191 BOILER9-H.P.EA <br /> ��R OA9 flRED AC.UNITS-TONN�OE EA <br /> KITCHEN DINK�D19P. FORCED AIN SY9TEM9-B.T.U. M E0. <br /> DIBNWA8NEN WALL NEATER�B.T.U. M <br /> IAUNOPV TMY UNIT NEATERS-B,T.U. M <br /> CIOTNE9 WASHER EVAPOMiIVE COOLEN9 <br /> WI17ER NEATER � CLOTFIE9 DRYERS <br /> URINAL VENTILATION FAN <br /> DRINKINO FOUNTAIN qANOE HOOD <br /> FLOOR DRAIN AIR HANOLINU UNIT- C.F.M. <br /> _ VACUUM BREIINER9 STOVE <br /> , ROOFDMINS-MINLEA�ERB METALFIREPLACE6CHIMNEY <br /> BINK BERVICE-B� ETC. WOOUSiOVE/FIREPLAG:INSERT <br /> iU�TOTAL HUlTOTAL ! <br /> PfI1MIT • ' ' PEqMIT • <br /> TOT11L F[[ • TOTAL FEE • <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> �IIONTNIMCK PFAR6EfMCK MOElETMCI( PLANCNECKNUMBEN VL�NCHECKiEE <br /> b � � �5/ J�I� FEE �� 3 g REGEIPTNO. � <br /> ��[- ' LOf�11E� � / <br /> YACANf ITE F[tl V111WT10N FE! <br /> C� � OYEB O <br /> T'►E OF f�OMlL� OCCUP�w6 i P NO.OF D O UNO UNIID , <br /> �J}r N <br /> ewioiNo s (g�qp, � �-� e� <br /> tuE or e�aa , Ho.a e�onie� uuc ax.�o�o <br /> �� � �� � PLUMBINO <br /> MECHANIC�L <br /> FIR[ PRINKLERS REOUIRED O YES NO <br /> OTMER <br /> PENALTY <br /> MRIGTqN�CC.lY PUNlGNECKEOlY AiPRFOR191UANLEBY <br /> �� �� � � T0TI1L <br /> �/�•�� <br /> i � <br />