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'�=APPLICATION F(;-� <br /> «��'°""' CONSTRUCTION e <br /> everett PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDINO DEPT. <br /> 259•8745 ❑ COMBINATION � BUILDINO ❑ MECHANICAL ❑ PLUMBIN3 ❑ SION <br /> ��%/� �!%i 7s' /�aor ,S;�D,DvREe3 d'//D /Y�r,�,IT �Jai f;� P�-eTl �a� ' .7J"8-/9/,3� <br /> IIPCNITECTOROESIONER M�IL ORESS CITY 21P PHON[ <br /> s23-e� <br /> pQryE��NTMC/,D'M f r d•�� E89t7d �f/ ��r�T/ /�/�Q,� o�o�G��99ys L^' �O�N� <br /> � <br /> i <br /> MECH�NIGICONTMCTOR �� MAtLAODF[39 CIIY 21P FNONE LICENlE• <br /> Xf•�. �' Y C'1 Ct' l♦ �C '( � ) <br /> PLUMlINOCONTMCTOR MAII�DDNE33 CITV 21P %10NE IICEN9E• <br /> CU39 OF Nq11N <br /> ❑ NEW ❑ ADDITION �I ALTEMTION ❑ REPAIR ❑ DEMO�ITION ❑ WOODSTOVE/FRPLINSERT ❑ BUILDINO REIOCATION <br /> V�LUA _ pFy(ORKt(�lTOOFOM�TERI�LBPLU9L�BOT <br /> Q <br /> /(% O <br /> DESCRIBEYVONN � � <br /> "' • X , , � <br /> . <br /> ux or euaoirw I HEREBY CERTIFY THAT I HAVE REA AND E%AMINED THI3 AP <br /> PLICATION AND KNO W THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEQAlDE9CPIPTIONOFPROFEPtY HOWNBELOWOR�TTACNFOURCO%E9� ppOVISIONSOFLAW3ANDOPDINANCES00VERNINOTHI3TYPE <br /> OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE <br /> tor_e�oc�_or IN OR NOT.THE ORANTING Of A PERMIT DOES NOT PFEBUME TO <br /> pIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVIStON3 OK <br /> ANYOTHER 3TATE OR LOCAL LAW REOUTATINO CONS�RUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIONATUP6 CO TOR O U IZEO�OENT O�TE <br /> ///O/�y <br /> VROJEC7ADDRE88 , `� yu�`j' �PP ��N79CITYBUSINES9LICEN9EN0. <br /> .�?//D l�a•i11 fli�P �/1?G�P=� <br /> PLUMlINO MECHANICAL <br /> ��� � NO. 7'�PE OF FIRTURE FEE NO. iYPE Of FOUIPMENT .I![ <br /> WATER CLOSET TOILE AIR COND.UNITS—M.P.EA <br /> BATNIUB REFRIOEfUTION UNIT9—H.P.EA <br /> UVATORY WASN BA51 BOILER9—H.P.EA <br /> � SNOWER 6A9 FIRED AG UNITS-10NNAOE EA <br /> KiTCHEN SINK6 DISP. FOqCED AIR SVSTEMS—B.T.U. M EA <br /> DISHWASHER M��LLHE�TER9—B.T.U. M � <br /> UUNDHYTR�V UNITMEATERS—B.T,U. M <br /> CLOTHE9 W�9HER EVAPOMiIVE COOLERS <br /> WATEH MEATER CLOTHE3 DRYER9 <br /> URINA� VENTIUTION FAN <br /> DRINKII;O FOUNT�'N RANOE HOOD <br /> FLOOR DRAIN Alp H�NDLING UNIT— C.F.M. <br /> V�CUUM BREAKER9 9TOVE <br /> RpOF DMIN9—RAINLEADERS METAL FIREPLACE 6 CHIMNEV <br /> SINK SERVICE—BAR ETC. WOOD9TOVE/FIREPLACE INSERT <br /> BUSTOTAL " SUlTOTAL � <br /> PERMIT { � - PERMIT • <br /> TOTAIFEE • � TOTALFEE • <br /> � THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> fRONf6ET0�GK REARSETB�CK SIUE6EiB�GK . PL�NGNECKNUMBER PLANCNEGKFEE • <br /> FEE REGEIPTNO. <br /> VSEIONE IOT�HEA y�C�NT81tE <br /> OYE9 ONO iEEt V�LUIITION �![ <br /> ttPEOFLONST. OCCUGANCYGPOUP NO.OFDWEI.LINOUNIT9 <br /> BUILDINO f <br /> 512EOf8LOQ NO.OfS10RIES M�ICOCGLOAU <br /> PIUMBIN6 <br /> MECHANICAL <br /> FIRE SPRINKLERS REOUIRED O VES O NO <br /> OTHER <br /> PENALTV <br /> APGIIC�TIONACC.BY PLANSCMELREOBY �PPP.FOR194U�NGEBY , <br /> TOT�L <br /> � � �� <br />