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''�'�'PPLICATION FO:�_�' <br /> `;,.� ��«n � <br /> tMEv�rprM� CONSTRUCTION ' � <br /> pTV OF <br /> everett PERMIT <br /> BUILDING DEPARTMENT <br /> 259-8745 TO BE COMPLETED IN INK• PIEASE PRINT <br /> ❑ DEMOLITION �COMBINATION ❑ BUILDING ❑ MECHANICAL O PlUM81NG ❑ SIGN <br /> OWNER M�IL�DORE55 Cltt 21P OMONE <br /> �i /�1 G���m�, .���,� �.��r � a,--�1�- 5�'aoi a�x-�c. �o <br /> MCMITECT OESIONER M�IL�DDRE55 Cltt 2iP PMONE <br /> 6ENEMLGONTF�LTOR M�IL�DDPE55 Cltt ZIP PMONE LICENSE• <br /> ! y1fB in <br /> MECH�NIC�L CONTMGT B M�IL�ODRE55 CiTY I�P FNONE LICENSE• <br /> VIUMlINOLONTpACiOR M�ILADDPE55 Cltt 21P PIIONE LICENSE• <br /> CLABS OF WONK <br /> ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIii ❑ DEMOLITION ❑ WOODSTOVEIFRPL.INSERT ❑ BUILOINO RELOCATION <br /> VAlWT1I0�NOF WOHN��;9T0'.'.)'M�iE��/S���AI�iJ / - `�J �y��A ,/� �7 ��./A�: <br /> � 7..f.� T �75L ��/ 5 � '��+�1T' / � / V � <br /> DE9CRI! WO K <br /> useor aoi , I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> PLICATION AND KNOWTHESAMETOBETRUEANDCORRECT.ALL <br /> �E ,u esc i rano PROPE11TY19NOWNBELOWONATT�CMFOURCOPIE51 PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> �I �II Q�{2 EU��rf Div R OFWORKWILLBECOMPLETEDWITHWHETHERSPECIFIEDHERE- <br /> �or_—e�ocrc.__or IN OR NOT.THE GRANTI NG OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR IOCAL LAW RE6ULATINGCONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SION�TURE OF CONiPACTOR OR AUTHORIZEO�OENT OATE <br /> X � - - 7 <br /> PIqJECT�ODPESS �PPLICANTSCITYBUVESSULENS NO. <br /> �M���Q MECNANICAL <br /> Np, TYPE Of FIItTUNE FEf: NO. TYPE OF EOUIPMENT FEE_ <br /> WATER CLOSET TOILE AIR COND.UNITS-H.P.EA <br /> BATHTUB REFFIGER�TION UNITS-H.P.EA _ <br /> LAVATORY WASH BA91 BOILERS-H.P.EA <br /> ' $HOWER OAS FIRE�AC.UNITS-TONNA6E EA <br /> � NITCMEN 91NK 6 DISP. FORCED AIR SVSTEMS-B.T.U. M EA <br /> DI9HWASHER WFLL MEATERS-B.T.U. M <br /> LAUNORVTFUIY UNITME�TERS-B.T.U. M <br /> CLOTHE9 WASMER EVAPORATIVE COOLERS _ <br /> W�TER NEATER CLO7HES DRVERS <br /> URINAL VENTILATION FAN <br /> � DRINKINO FOUNTAIN P�NGE HOOD <br /> ' FLOOR DM�N AIR HANDLING UNIT- GF.M. <br /> VACUUM BREANER9 STOVE <br /> ROOF OM�N8-RAINLEADERS METAL FIREPLACE 6 CHIMNEV <br /> � $INK 9ERVICE-BAR ETC. WOODSTOVE/FIREPLACE INSERT <br /> 6U!TOTAL BUB TOTAL t <br /> . PEIIM�T t PEIIMIT { <br /> TOTALFEE • TOTALFEE t <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> FIqNTlE}�K pH�p 6ETy�CR SIOE SETMGK PL�N CHECN UMBEP PL�N CMECK FEE M <br /> ^ U ^ �� (�� �� �Q/��/� FEE�I� PEGEIPTNO.�y.� �� <br /> v �- �.J p�J oti c� � <br /> WE20NE LOTME� VAGWT ITE F[Ft YI1LWTqM F!! <br /> �,"a b�� OYES �!O <br /> IYPEO�}115T� OCCUMNC�POUP HO.OFOWE�NOUNITS � <br /> y 8 5Ki R <br /> BUILDiNO f <br /> !RE Of NYY� NO.Of 6TORIE! M�X����� <br /> G/ / PLUMBINO <br /> 1 �e <br /> MECMANIUL <br /> FIRE PRINKIERS RE UIRE� O YES O NO <br /> OTMER <br /> PENAL�Y <br /> } IVpLICATqN�CC.BY VIANSCHECREO BY APPR.FOH iSSU�NCE BY <br /> TOTAL <br /> i � � L •G <br /> , <br /> ,, <br /> i <br /> , __ ____, __. . <br />