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fM r�� <br />qP/ OF <br />everett <br />BUILDING DEPARTMENT <br />269•8810 <br />r <br />, PLICATION FOR� . ����Q eYt,�„ <br />�CONSTRUCTION �3�.5��2 e . <br />PERMIT <br />TO BE COMPLETED IN INK • PLEASE PRINT <br />O DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL O PLUMBINO 0 SIGN <br />OWNER M111L��ORE`�5 Gltt 21P PHONE . <br />` <br />e..ve v✓.,�8 �nn/� (�na,, �; �iiP <br />OENERAL LJNiR�GTOR M1111 �ODRE55 C�tY IIP PHONE LICENSE • <br />— ` ' ' - - "-- —"' .- �—., ., i�ln w. �, .fr_ [r..,l.. RQ�o.. 22cL d.th COcren �-rs <br />M�IL <br />VLUMBINOLONTHACT/OR M�iL�ODAESS CIfY 21P PIIONE IICENSE• <br />IP.1. ��� �\t 11AA{(11 /V� ' .. � <br />CL�SSOF WORN � <br />� NEW ❑ A�DITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTO�E/FRPL.INSERT ❑ BUILDING AELOCATION <br />veWwnun er v��� rv��� ... ..._.......,_ . __� _... <br />'� 9�'i�Ct� � <br />OESCR�BE WOFIt <br />.�,,.,.� ��,.,n�i� _ tAP�,J �fP_Sli <br />wi � <br />PLUMSIN6 <br />NO. TYPE OF fl71 <br />WIITEP CLOSET ITOILE <br />BATNTUB <br />U�ATORY�WASM BAS <br />SNOwER <br />NITCHEN SINK 6 DISP. <br />DISHwASHER <br />IAUNDRVTRAV <br />CL07HE3 WII9HER <br />URINAL <br />DRINKIN6 FOUNTAIN <br />FIOOR ORAIN - <br />BACNFLOW PREVENTE <br />ROOF DRAIN9 — R�INI <br />SINN ISERYICE — BAR. <br />WSTOTILL f <br />iE11MIT 1 <br />TOtAI FfE f <br />__. Z. � __ _ �. <br />.'ONE� � LOTARE� <br />� N <br />IOFGONSi. OGCUP�NCYGROUI <br />- y' - � !2- 3 <br />.OF 9i0a NO OF STOPIES <br />II <br />.� <br />DN �CC Bv VL�N9 CHEG1cE� BY <br />�� �� <br />r <br />SIDE SETBACK � <br />�. S <br />VACANT SITE <br />OYl6 ONO <br />�.� <br />NO.OF DWELLINO UNITS <br />er <br />��� <br />I HEREBV CERTIFY THAT I NAVE HEAD AND EXAMINED THIS AP• <br />PLICATION AND KNOW THE SAMETO BETRUEANDCORRECT. ALL <br />PROVISIONS OF LAW S AND ORD INANCES fiOVERNI NO TNIS TV PE <br />OF WORK WILL BE COMPLETED WITH WMETHER SPECIFIEO MERE- <br />IN OR NOT. THE GRANTINQ OF A FERMIT DOE3 NOT PRE3UME TO <br />OIVE AU7HORITY TO VIOLATE UR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW PE6ULATING CONSTHUCTION <br />OR THE PERFORMANCE OF C:ONSTRUCTION. . <br />914N�TURE OF CONTHACTOR OR AUTIIORIZED AOENT O�TE <br />X �71u�.�,�. Ft�t..QL. ?-/4-.►�' <br />MECNANICA� <br />OF <br />NC —A/17NDlO UNIT9 — H.P. <br />HEFRIOERATION lIN1T5 — M.P. EA. <br />ev��ena — o. �.u.in.r. <br />(i�13 FIRED A�C. UNITS — B.T.U. <br />( <br />FORCED AIR 9YSTEM3 — B.T.U. <br />WALL MEATERS — B.T.U. <br />UNIT HFATERS — B.T.U. <br />EVIIPOMTIYE COOLERS <br />CLOTMESDRYERS <br />VENTILATION FAN <br />MNOE MOOD <br />WATERMEATER <br />METAI FIREPUCE 6 <br />FIREPLACEINSERT <br />MEATPUMP <br />OAS PIPINO <br />E%HAUSTFAN <br />PLAN CHECK NUMBEH <br />Ft$ Zoyy6 <br />FEES <br />BUILOING <br />PlUM81NG <br />MECHANICAL <br />STATE BUILDINO SURCN�RGI <br />STATEENERGYSURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />TOTAL <br />FEE RECEIPTNO. <br />3 �i �° �D7 <br />.`� <br />PROPERiY OWNERS ARE HESPONSIBLE FOR <br />PROPERTY LINE IOCATIONS AND RELAiED E <br />^-nar:-r,:r.r„^rr.c-:,,�-h-:-._ .. -urxar.-.z-t�-�-�-..._,.. .. . .. ..... .. .. .. <br />