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i <br />� <br /> ,ME,,,,�.� ��PLICATION FO1:`�' ev�,�„ <br /> °�TM°° CONSTRUCTION <br /> everett PERMIT e <br /> TO BE COMPLETED IN BLACK INK- PLEASE PRINT <br /> BUILDING DEPT. <br /> 259-8745 � COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNEF MML�DORE55 CiTY I�P n�ONE <br /> ARGHIPAU SGN�• KUKOWSfKIRE55 ��IS �A" Lf' " F���N� i/ P f` � 1I IwON� � ' �� Z <br /> GENER�ICONTp�CTOF MMLADONF55 CIIV LiP prypNC �ICCNSE• <br /> MECM�NiCMCONTR�CTOq M�IL�DORE55 CRY 2iP PHON[ UCENSE• <br /> PIUMBIN4CONTp�GtOR MAIL�ODFE53 CIfY ZIP nnON[ IiCENSE• <br /> C1�53Oi WORK <br /> ❑ NEW ❑ AD�ITION � ALTERATION � REPAIR ❑ DEMOLITION ❑ WOOOSTOVE/FRPL.INSERi ❑ BUILDING REIOCATION <br /> W W�TIDN Oi WpRN IfASt Oi M1tERI�LS PLOS L�BON� M <br /> t'�z�o �; <br /> OESCRIBE WOpN <br /> sr_� ATiACNF_D <br /> USE Oi BUILOINO <br /> �/N�L.� FA/11 i�-� I�F-S l�Lr,t1GE � HEREBY CERTIFY THAT 1 HAVE READ AND EXAMWED THIS Ap• H �„� <br /> PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL y M <br /> LEGA�DESCRIPtIONOF^ROPENTY�SHOWNBELOWOR�TT�CMFOURCOP��E/51 pROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPE <br /> �ot���ocK3G'�r V E T v OFWORKWIILBECOMPLETEDWITHWHETNERSPECIFIEDHERE tn � <br /> IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO � <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL 1HE PROVISIONS O� <br /> LOT o vF f�T Di✓ K ANYOTHERSTATEORLOCALLAWREGUTATINGCONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. y <br /> SIGNA7UREOFCONIRACIOROf1AUiNO�I.EO FNI q1E � <br /> X'��_-�.�� lai. / �L�.t, � y � 6 S ���]] � <br /> VROJEGfADORE55 �PVLICAN�SCIIYpU5WL55UCCT1$[Np, � 7" <br /> /8 /7 OA. ,��"S � <br /> � H <br /> PLUMBINO MECHANICAL N <br /> _ N0. 7YPE OF FIKNRE FEE HO. TVPE OF EOUIPMENT FEE �O � <br /> WATER CLOSET iOIlE7) --"' �1 <br /> ( AIR COND.UNIiS-H,P.EA. <br /> I BATHTUB � REFRIGERATION UNITS-H.P. EA � <br /> IAV�TORYIWASH BRSIN BOILERS-II.P.EA. H <br /> � <br /> SHOWER GAS fIREO AC UNIiS-TONNAGE EA � <br /> NITCHEN SINN 6 DISP. FORCEO AIR SYSTEA75-B.T.U. M EA. <br /> OISHWASMER WALL MEATERS-B.T.U. M y <br /> LAUNDRVTRAY UNITMEATERS-B.T.U. M • � <br /> CIOTHES WASHER EVAPORATWECOOLERS <br /> WATER HEATER CLOTHES DRYERS <br /> URINAL yENTILAiION FAN yy <br /> DRINKINQ FOUNTAIN RANGE IIOOD �� T <br /> FLOOR OR�IN AIR HANDLIN6 UNIT- <br /> CFM z <br /> VACUUM BPEAKERS S10VE y <br /> ROOF DRAINS—RAINLEADERS METAL FIREPLALE d CHIM1INEY �.�y <br /> SINK�SEFVICE—BAR ETC. WOOOSTOVE/FIPEPIACEIN$[RT yz <br /> --- H <br /> _—_ f(y� <br /> — — (*7 <br /> 6UB TOTAL B� SUBTOTAL S � <br /> PEqMIT 3 PERMIT S <br /> TOTALFEE { TOT�LFEE 7 <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> iRONiSEiB�CK REAqSETBACK SIDESEi6�GN {qANd1CCNNUMOI❑ pIANCUECKfCF <br /> NA� �L,� ��, �. �� %y .s7 «<�� q 3 �«���J�„�� ,�o <br /> USE ZONE �OT�RE� y�CANT SI1E —• '�� <br /> 2'� L7JU ❑YES pf10 FEES V11lU�T10N FEE <br /> TYPEOFCOHSt OGCUP�NCYGROOP NOAFOWELUNGUNIiS <br /> �—N �-3� / d���o�N� SSZ70. `� " sv <br /> SRE OF 9L�Q NO.OF STORIES M�K OCC L0�0 <br /> 9�O C� PI.UMOING <br /> MECHANICAL � /Ll— <br /> FIRE SPRINKLERS REOUIRED ❑YES � NO «l <br /> OTNER <br /> PENAL7Y <br /> APPLICAIION�CC.BY PL�NSGMELNEDBY ,1PCRfOR155U�NCEflV � <br /> C�' /J J2 I"� G . C TOTAL _—__ ____'_ _'__ O J 1�( <br />