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'���� A ����LICATION FOR � � � � � � � � <br /> '.� «��"" CONSTRUCTION JUN U 1 198 <br /> �� <br /> eVerett PERMIT .. . <br /> .CITY �Of EVERE <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK- PLEASE PRINT <br /> r 258•8745 PuWiC WOrks Dept <br /> ❑ DEMOUTION ❑ COMBINATION ❑ BUILDING �MECHANICAL ❑ PIUMBING 0 SI(iN <br /> OWNIR MML�ODRESS CIiY 21P PMONE . . <br /> - Maurice Olson 6034 Maiwr Place �erett 98204 353-9428 • � ` <br /> ` MGNI7ECTORCElIONER M�ILADCRE89 CiN 2iP ' PMONE . - <br /> OfNfMLCONTRAGTOR MAIL�DOHE53 GN IiP PNONE LICENSE• <br /> 'MECHAM�C�LOONTMCTOq M�ILADONE43 Cltt � 21P PHONE UCENSE• <br /> Reliable Sheet Metal. 11447 120th Ave NE Ki.Y'kland 98033 823-6868 RE-LI-AS-M4-3i <br /> PLUM�INOGONTF�CTON . M�LLAUDRESS Cltt Z�F P110NE LICENSE• <br /> C1A660F WORK <br /> ❑ NEyV ❑ ADDITION L� AITERATION ❑ REPAIR ❑ DEMOLITION ❑ WOOD9TOVE/FRPL.INSERT ❑ BUILDIN6 FEIOCATION <br /> VALWTON OI WORIt ICOBT OF M�TEHiAL4 PW e L�BOPo <br /> O4lCRI�E WORK <br /> lac�ent of f�nace hot water heates and install 1 boiler i <br /> Y�EOf W��DINO I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS AR <br /> 1 Residaue PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL <br />'� L[O�LD[lC111PTIONOFVROVERTYIHNOWNlELOWOR�TTAGNFOUPCOPIEW PROVISIONSOFLAWSANDORDINANCESOOVERNIN�THISTYPE � <br />?� OF WORK WI LL BE COMPLETED WITH WHETH ER SPECIFIED HERE• <br />� �or—e�oc�—_oa INORNOT.THEGRANTIN60FAPERMITDOESNOTPRESUMETO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL TME PROVISIONS OK <br /> ANYOTHER STATE OR LOCAL LAW PEGULATINOCONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SION�TURE OF CONTRA OR OR AUTMORIZEO�OENT DATE <br /> X (J. ���23/ <br /> ' FlqJECTADDRE!! �PPL�CANiSCIi 51 ESSLICENSENO. <br /> �' KUM�INO MECN�NICAL <br /> NO. TYPE OF il%TU11E FEE NO. TYPE Of EOUIPMENT R!E <br /> ' WATER CLOSET TOII.E AIR COND.UNITS—H.P.EA. <br /> o•�: ,. �m�B REFRIOEF�TION UNITS—H.P.EA <br /> UV�TO?Y'WA9H BASI BOILENS—H.P.EA. <br /> , . . 8N0�R OAS FIRED AC.UNIT9—TONN�OE EA <br /> � KITCMEN 81NK�DISP. FORCED AIR SVSTEMS—B.T.U. M E <br /> DISMW�BNER WALL HEATER9—B.T.U. M <br /> � UUNDHVTMY UNITHEA7EFS—B.T.U. M <br /> CLOMES W�SHER EVAPGMTIVE COOLER9 <br /> WIITER MEATER CLOTHE9 DRVERS <br /> � URINAL VENTIUTION FAN <br /> � DRINKINO FOUNTAIN RANOE HOOD <br /> FLOOR DRAIN �IR HANDLIN6 UNIT— C.F.M. <br /> VACUUM BREAKER9 STOVE <br /> ROOF OMIN9—RAINLEADERS MET�L FIREPLACE 6 CHIMNEV <br /> � 81NK 9ERVICE—BAR ET0. WOODSTOVE/FIREPLACE INSERT <br /> 1 Hot water heater <br /> BUlTOTAL BUBTOTAL � <br /> PERMIT t PERMIT � <br /> TOTALFEE • TOTALFEE � <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> FqONTSETBACK REARSETB�CK SI�E9ETB�CK VL�NGHECKNUMBER VUNCHECKFEE <br /> FEE RECEIPT NO. <br /> USEZONE LOTAREA y�C�NiSITE pEEB V11LU�TION FEE <br /> OYES ONO � � ,'j-�: <br /> Q <br /> IYPEOFCONBT. OCCUPANCYGROUP NO.OFOWEllINOUNITB <br /> i <br /> BUILDINO s <br /> lIZE OF BLDQ NO.OF STORIE9 MA%.OGC.IO�D <br /> � - � PLUMBINO <br /> MECH�NICAL <br /> F R P INKLERS REOUIFED O 1'ES O NO OTMER � <br /> PENRLTV <br /> APFUCATION�CC.BY PL�NS GHECRED BY APPR.FON 195UANGE BY <br /> TOTAL <br /> i <br />� <br />�� . <br /> j� w.n '--.n•-�rm•., ..-r, ^. .: -;?t:SrC'.il.:. ..., n .. _ . . ...."' . . . . �, . . . .i:...... .. �`%T .. ',i�"• <br />