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�,E„ro�,� . .PPLICATION FO..' ���,�„ <br /> ��ry� CONSTRUCTION „� <br /> everett PERMIT <br /> BUILDING DEPARTMENT <br /> 259•87a5 TO BE COMPLETED IN INK- PLEASE PRINT <br /> ❑ DEMOLITION fiTCOMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑SIGN <br /> OWNEH MML�ODRE59 CITY ZIP PHONE <br /> ,� �t� �,/1 I f.� 3�,U L //D�7�'N (�Fj:r'T L.i � ) yc �. <br /> ARCNITEC70POESIONER MAILADORE59 Gltt 21P PHONE �I <br /> J �F� C 0 lf 1' �1n�� L1rI=S Nql11��n <br /> OENERIILCONIR�GTOR M�II�ODRE99 CITY 21P PMONE LILENSE• <br /> �,. jli.�A��� (cr1-Sl 11 ;2 �!�/NC�iNOA�E lle;'. Fi�" •� (4r Lii- ) ql� �"'°W+cNZ3< v� <br /> MECNANICQGONiRl1GiOR M�IL�ODHESS CITY 21P PMONE 4CENSE• <br /> YLUMOINOCONTP�CT(IR MAllA00NE99 CITY IIV PI�ONE LICENSE� <br /> 1�.9 ��[ I.f f'"��-rf S K�'crrr•`R C•1r���:R � �'i - � i�•' <br /> CL�59OF WOf11t <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILOING RELOCA710N <br /> WLU�110N OF WOFR IC09T OF M�1ERi�L9 PW 5 L�BOPo <br /> � �?C'Vt� � <br /> DESCPIBE WORk Y��� ��� �� I <br /> Ih3fi�. hfV /Slo4i �<«n�rre�� Fs'°F� NFHrs,,.�.,�hF�alvG'1� gF�_utC� It � T�.�i'r� 1�rl�t� /'��liiji[ I},��4ro�,.,r•� i <br /> useovevaoma I HEFEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> FFS�nh� ��f PLICATIONANDKNOWTHESAMF.TOBETRUEANOCORPF.CT.ALL <br /> lE0�L0ESCPIVfIONOFVROPER7Y�9NDWNBELOWOHATT�CMFWRCOPIE3� pROVISIONSOFL�WSANDORDINANCESGOVERNINGTHISTVPE <br /> 4 R�nj ' N� Ai� i° �°�r��f OFWORKWILLBECOMPLETEDWITHWHETHERSPECIFIEDHERE <br /> �orl�e�ocK—ov 1 IN OR NOT.THE GRANTING OF A PERMITDOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REOULATI NG CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTFUCTION. � <br /> SIONATUPE OP CONiR�CTOR OR�UTHORI2ED�OENI O�TE <br /> y-/67t. <br /> X � ' �-��i...( <br /> PROJEGTADOPEbS �PPLICANTSGITV BUSINES54CENSE N0. <br /> jGu L �..tit'fCr <br /> PLUMlINO MECHANICAL <br /> NO. T'FE OF FI%TUNE FEE NO. TYPE OF EOUIPMENT FEE <br /> � WATERCLOSET�TOILET) A�ACOND.UNITS—H.P.EA <br /> I BATHiUB REFRIGERATION UNITS—H.P.EA <br /> I LAVATORY WA9H BASiNI BOILERS—H.P.EA. <br /> SNOWER OAS F�RED AC.UNITS—TONNAOE EA <br /> � KITCMEN SINKB 019P. FORCED AIR SVSTEMS—B.T.U. M ER. <br /> DI9HW�SHER WALL HER7ERS—B.T.U. M <br /> LAUNORV TRAV UNIT HEATERS—B.T.U. M <br /> I CLOTME9 WASHER EVAPORATIVE COOLERS _ <br /> I WATER HEATER � CIOTHES DRYERS _ <br /> URINAL � VENTILATION FAN <br /> DRINI(INO FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN RIR HANULINO UNIT— C.F.M. _ <br /> VACUUM BHEAKERS ' STOVE <br /> ROOF ORAINS—R�INLEADERS METAL FIPEPLACE 8 CHIMNEY <br /> SINK SERVICE—BAR,ETC. WOODSIOVE/FIREPLACE INSERT _ <br /> SUBTOTAI 9UBTOTAI 3 <br /> PERMIT t PERMIT ! <br /> TOTALFEE ! TOTALhEE f <br /> � THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSO�VNEL <br /> �pON�5Ef8�CK BE�RSEIB�CK SIJESETB�CK �L�NCNECRNUMBER PUNCHECKfEE <br /> fEE RELEIPT NO <br /> 113E 20NE LOi ARE� VAC�NT SIIE V��U�TION FEE <br /> OYES ONO FEES <br /> TYPEOiLGNSi. OCCUP�NLYGPOUP NO.OFOWELLINOUNITS <br /> BllIL01N0 s <br /> SRE OF B100. NO Of S10R�E3 MA1C OLG lOAD <br /> PLUMBIN6 <br /> MECHANICAL <br /> FIRE SPRINKlERS REOUIRED O YES O NO <br /> OTHER <br /> PENPLTY <br /> �PPlIC�110N�CG.BY PLANS CIIECKED BY �VVF.FOR ISSUANCE BY — <br /> n TOTAL <br /> L 'G� <br />