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' APPLICATION F'C�R everetl <br /> ,"'E""°'"" CONSTRUCTION e <br /> �in�F <br /> everett PERMIT <br /> TO BE COMPLETED IN BLACK INK- PLEASE PRINT <br /> BUILDING DEPT. <br /> 259•8745 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL � PLUMBING ❑ SIGN <br /> uWNEA M<iL�DCn[55 Gir ziP m�uv[ <br /> �fT`( oF EtG—t��-C`I aaoz u�imoRr e��z�z7 9f�I 'S9 Q70( <br /> ARCMIIFC�OADESiGNER M<�I�DCC55 p�,�.� Cirv I�(P �'nONE A�l� <br /> �-�1l=PlN��s '�1'_ ..f1��l2St [�-i�tr [1����(�( C{:)�ZU � �cic� � S <br /> MP'�LADORC55 p�V IIP IY�Ot�f lll'frySE• <br /> 6ENCRALCONiR�CiON . � J , . � ' I ��� �.�'� . <br /> .� � ,-�- r.�__ -'1. i ! ,,�r<-. : ,( ., - lF• , <br /> NE �NiG�L GONiR�GIOfl J MeR AODRE55 \ Ciiv \�IiP i'uO�Q UC[NS[• <br /> �IUMBINGCONIR�CTOR M�4AOONESS C�rv I�V FnON[ I�LFNSE� <br /> CL�55Oi WORN <br /> ❑ NEW ❑ ADDITION ALTERATION ❑ fl[PAIR ❑ DEMOLIiION ❑ \VOODSTOV[/FRPL.INS[RT ❑ BUIIDING R[LOCATION <br /> W W�IION OF WOAK�COST OI M�iEPUtS PW 5 LABO�tf. <br /> � J� �� �� ' 'J - <br /> � <br /> oescni�EwonK MM4Nl�hW15 f7�ct�• u. � I�i' �� ! ' <br /> �.�K70tlC' �� <br /> useoreuaort+c - 5 I HEREOY CERTIFY THAT I HAVE RE�D AND EXAMINEO iHIS AR <br /> EK�SI LliS�' dFr'/R� n�ti -L')�'` L'�''� PLICAiIONANDKNOW7HE5AM[TOBETRUEANDCORRECT.ALL <br /> IEG�LUE5CNI0ilONOfFROPLNiY�SNOWNpEIOWO�i�I1ACNLOU�LOPIE51 PROVISIONSOFLAWSANDORDINANGESGOVERNINGTHISTYPE <br /> OF WORK WILL BE COMPLETED WI1H WHETfiER SPECIFIED HERE- <br /> i.or_eiocrc_ov IN OR NOT.THE GRANTING OF A PC-FMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLAIE OR CANC[L T11E PROVISIONS OF <br /> ANYOTHER STATE OR LOCAL LAW REGULATINGCONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUC110N. <br /> SIG�� T.'RE OF CONiRAC10R OR n11iHO�IZFO/G[Nl CniE <br /> X � 1 ( �(,Utf�--t� `(-I�i '� <br /> PflOJEGtADDf1E5$ �C iLf �SC11Y USIN[S51 :NSLND <br /> / <br /> O� �� L / <br /> PLUMBINQ _ _ MECHANICAL _ _ _---- � <br /> NO. TYPE OF FI%TURE FEE __ NO. TYPE OF EOUIPMENT _ FEE _ _ <br /> �__ WATER CLOSET�TOII.ETI �_ PIR COND UNI IS-H P. E/ _ _._ - - <br /> BAiHTUB ______ �EfRIGERAlION UNIIS-11 P.EA _ __ _. . <br /> LAVATOHY�WASH OASINI __ BOILERS=H.P E�.______._ __._—_- . <br /> �- -- GAS FlR[D AC UNrtS-TONIJAGE EA_ _ _ . <br /> SHOWER - -- ' - - -- <br /> KITCHEN SINK 6 DISR .`_ fORCED AIR SVSiE1d5-B T.0 M EA. _ ._. . <br /> pl$HWASHEFi _ � WALLNEAT[RS-O7.0 h1 ____ _. . . � <br /> LWNDRVTRAV UNITHEATERS-O.T.0 !d _�_ � <br /> _ � - - — — H <br /> _ CLOTHES WASHER _ [VAPORATIVE COOLF.fiS _ <br /> Ani[R MEAIER __ -- <br /> CLOTHES ORYERS � <br /> URINAL VENTILAt10N fAN <br /> DRINKING FOUHTAIN _ RANG[HOOD _ __ -- <br /> FLOOli DR41N AIR HANDLING LNIT- GF M. - <br /> VACUUM BREAKEFS S70VE — H �- <br /> ROOF DRAINS-RAIIJLEADERS _ ___ MEiAL PIRCPLACF A CHIMNflV _ � � <br /> SINK �ERVICE-DAR,ETG _ _ �VOODS10VEiiIREPLACE INSERT _ -- � �' <br /> K <br /> -- --- _ � � <br /> -- _ �" <br /> _ <br /> — -- -- � �: <br /> SUB TOTAL - _ ___SUB TOTAL _ 5 ____ __ f' <br /> PERMIT S �`J _ _ _PERMIT.______..5 _ __ -- � � <br /> —' TOTALFEE S _J� ___ ___"_ TOTALPEE____ 's�_ _-'_'--.-- <br /> —_ "_ � : <br /> THIS PORTION �O BE COMPLETED BY BUILDING DEPT. PERSONNEL � ` <br /> VUN�]ICLnlFf {� N� / / � � <br /> FqONi5E18ACK �E�ASEIOaCh SID[SC.fB>Ce PUNG�ICCnNUM1�O[N � <br /> s �'� <br /> . ,�!cnri„o <br /> EX/si C --� r1�y/l-� `�.7G .�c �/� � _ � `� <br /> USEIONE .J�AA�� y��arviSilE FElS VALUATION fEE � �° <br /> �-3 2 ��,� ��.�s �;�o � <br /> ttPEO�CONS� I OCWI'ANCYGROOP NOOfpW[LLOIGUNIIS _�Gi�J]p�r� _____ - <br /> ����•�' ��' L J dUILOING E-✓-'7�L✓�_ � / S� <br /> Si2E O�flLOG HO Of S10PiE5 M�r ^CC.lU�O <br /> � �9 ? � PL1141BING 1 �_d <br /> 7� ,r(�� L z � . <br /> h1EUlANICAL • <br /> FIRE SPRINKLERS RE�UIFED ❑ YES . NO <br /> � Oi11E11 <br /> PBNAITY _ <br /> APPLICAiION�CC BY �'LANSCM[CNEDBY �PI'9 fOR155UANCCBY p/ / � <br /> i TOTAI ___I d (7 J D � <br /> L=��' r��� L C ------- ---- <br /> � c <br /> � ,- - � j .�" � } '. , - �. <br /> i��, <br /> (��. _♦ `,''._ � . <br />