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. .PPLICATION �0.. ���,�„ <br /> '"'`�°"'" CONSTRUCTION 0 <br /> an or <br /> everett PERMIT <br /> BUILDING DEPARTMENT <br /> 259•8745 TO BE COMPLETEil IN IPIK- PLEASE PRINT <br /> O DEMOIITION O COMBINATION �BUILDINO ❑ MECHANICAL ❑ PLUMBINO ❑SION <br /> ���� M�iL�DO�F!! cirv zin PHONE <br /> v�,�uA� C �Ro��u�n�,/ 2511P�^►E s�' ���y1' 9s.t�� ��-6�4s _ <br /> •RCMIfE'C•T'O'R',O`ES�nONER M�Il�00RE19 Gltt Li� PMONE <br /> �N/�D�` <br /> OENEP�L CQNiN�GtON M�R A0�11[SS CRV ZIP P�iONE IiCCvSF • <br /> �. Ic/� <br /> l%WI..r/� <br /> MEGMIINIC�LCON1M�CTOR MML�DOPE54 CpY :IP PHONE UCENSE• <br /> N/R <br /> RUM��NOCONIpI�CTOR M�IL�UDN°49 Cltt IIP PIIDNE LILEuSE• <br /> N/.� <br /> C1�57 Oi wONK <br /> ❑ NEW ❑ pDDITION ❑ ALTERATION � REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDINO RELOCATION <br /> V�W�TION Of WO�K ICOlT OF M��E�uL9 VlU3 L�lOPo <br /> °;e"a���- Cs-r�P i'�,�l�ar,�����ns� s�,� o� ,�s��,� -�� �/ ��. �.� ���6� <br /> use o�ew�oY+o I NEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS AP• <br /> rJup/EJ� ' O(�(.K�Ei2 OGGC//7/�D pLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALI <br /> IEO�LDElCRIPTIONO�PROVER��iSHOWNlEIOWOA�iT��H�OUHCOPIE91 pRO�I510N50FlAWSAN�ORDINANCESOOVERNINGTHISTVPE <br /> � , 2 ) S . OF WORK WILlBE COMPLETED WITH WHETHER SPECIFIED HERE• <br /> �oi—e�ocK—or IN OR NOT.THE 6RANTIN60F A PERMIT DOES NOT PRESUME TO <br /> fiIVE AUTHORITY TO VIOLATE OR CANCEI THE PROVISIONS OF <br /> „ � ANYOTHERSTATEORLOCALLAWREOULAT�NaCONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTiiUCTION. 7 � <br /> $ION�T���CT�RA�ZEO ENT D�fE,�� �/G)I��i <br /> X � � ��L / <br /> i� <br /> VROJEGT�DOPE59 � �PVLIC�NTSQTYBUSINE59lICENSENO. <br /> asu ��� � ��� �. �i9y�� � .� <br /> PIUM/INO MECNANICAL ____ <br /> NO. TYPE OF FIXTURE FEE NO. TYPE Of[OUIPMENT FEE <br /> WATER ClOSET ITOILEII AIR COND.UNITS—H.P.EA. _ <br /> B�iNTUB __ REFRIOERATION UNITS—H.P.E�. _ _ <br /> IAVATORVIWASM BASINI BOILERS—H.P.EA. _ _ <br /> 3HOWER OAS FIRED AG UNITS-101..�AOE EA _ ____ <br /> KITCNEN SINK 8 DISP. FORCED�IR SVSTEMS—B.T.U. M ER. _ <br /> UISHWASHER WALL HCATERS—B.T.U. M <br /> LIIUNDR�TA�Y UNITHEATERS—B.T.U. M _ __ <br /> CLOIHES WASHER EVAPORATIVE COOLERS __ <br /> WATEP HEAiER CIOTHES DRYERS ___ <br /> URIN�L VENTILA7�ON FAN <br /> DRINKINO FOUNIAIN RRNGE HOOD _— <br /> FLOOR OR�IN AIR HAN�LINO UNIT— C.F.M. __ __ <br /> V�CUUM BREAKERS STOVE — <br /> ROOF ORAINS—RAINLEADERS METAL FIREPLACE 8 CHIMNEV __._ <br /> SINK ISERVICE—BAR.ETC.1 WOOUSTOVE/FIREPLACE INSERT _ _ <br /> I — <br /> I _. <br /> SUB TOT11L SUB TOT11L ! _ <br /> PERMIT f PERMIT � __ _ <br /> TOTALFEE i � TOTALFEE � _ ._._ <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> iRONISEIB�Ltl �l(ARSl10ACK $IOESEIBACN PL�NCIIECKNUMBER PI�NG�ECe�EE <br /> FEE HECE��I NO <br /> USE20NC Lof�nU V�G�NISrtE FE[9 WWIITION FEE------ <br /> pYES ONO <br /> TY1`EOfLONSt O[CUI`���CYf.NOUP NO.OFDWELLIN6UNR5 ___— <br /> Bl11LDIN0 S <br /> ❑�ZE OF plDO NU 01 S10RIE5 M�X OCG LO�D <br /> PLUMBING <br /> MELHRNICAI <br /> FIRE OPRINKIERS REOUIR[D ❑ VES ❑NO <br /> OTMER <br /> FENALTY _ <br /> APPI�C�110N�CC BY VUNSC��EGNEOBY APPR.i0R155J�NCEBY <br /> TOT�L <br />