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. .PPI.ICATION FO�. ' <br /> '".`"ro"'° CONSTRUCTION �°"`" <br /> un ov <br /> everett PERMIT e <br /> BUILDING DEPARTMENT <br /> 259•8745 TO BE COMPLETED IN INK- PLEASE PRINT <br /> �DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑SIGN <br /> OWNER M�IL�UDRESS CITY IiP PMONE <br /> ��L �►'l1 W /h+ i<[�/Z. .��°6 /►+rAF'C�= /�Ur/L,e'rT .� 58- /�- o j <br /> �RCMifEGTORDESIONER MAIL�DORE59 �Itt ZIP PNONE <br /> GENERALCONTHeGTOH M�IL�UDRESS GITv 21P PMONE �iCENSE• <br /> MEGH�NIG�LCONTRIGTOq MAII�OpNE55 CITY 21P PNONE ULENSE• <br /> PLUMBINOCONiR�GTOq M�ILAODRESS CITY IIP PIIONE 4CENSE• <br /> Cl�$S OF WORN <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR �EMOL1710N ❑ WODDSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION <br /> V�lU�1�ONOiWORN�LOSTOfM�iERI�LSPLUSLIIBOPo � <br /> DESCR�Bf WORN ' / c <br /> _ � ��l.! ✓�� <br /> USE OF BUILOINO <br /> S Nr I HERFBV CERTIFY TNAT I HAVE READ AND E%AMINEO THIS AP• <br /> PLICAfION AND KNOW THE SAMETO BE TRUEAND CORRECT.AlL <br /> lEOALUE4CRIPtION'1FPROPENIY�SHOWNBEtOWORAITIICHFO�RCOPIES} pROViSI0N50FLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br /> �or__eioc�or IN OR NOT.THE GRANTING OF A PERMIT OOES NOT PRESUME TO <br /> � GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> �I� C� . � ANYOTHERSTATEORLOCALLAWREGULATINGCONSTHUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIO4qTUREUFCONTPRCfORORAUTHOfl12E0AGENT OATE <br /> X � �` � ��� �y�� <br /> E�� <br /> PROJEGT�DORES9 �PPLIC�Ni9 GiY BUSINESS LICENSE NO. <br /> a �vG ,," /��� �u - � .- <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE fEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET TOILE AIR C�ND.UNITS—H.P.EA. <br /> BATHTUB REFRIGERATION UNITS—II.P.EA. <br /> LAVIITORY WASH BA91N1 BDILERS—H.P.EA. <br /> SHOWER ORS FIRED AC.UNITS—TONNAOE EA <br /> KITCMEN SINK 6 OISP. FORCED AIR SYSTEMS—B.T.U. M EA <br /> DISHWASHER WA�L HEATERS—B.i.U. M <br /> LRUNDRYiRAV UNITMEATEPS—BT.U. M <br /> CLOTMES WASHER EVAPORATIVE COOlERS <br /> WATER HEATER CLOtHES DRYEHS <br /> URINIIL VENTI�ATICN FAN <br /> ORINKINO FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— C.F.M. <br /> VACUUM BHEANERS STOVE <br /> ROOF ORAINS—R�INLEADERS METAL FIREPUCF 8 CHIMNEV <br /> SINK SERVICE—BRR,ETC. WOODSTOVE/FIRf:PLACE INSERT <br /> , SUB TOTAL 8UB T0TI1L f <br /> PERMIT f PENMIT f <br /> __ TOTALFEE ! TOTALFEE t <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> FRONiSETB�CK BE�HSEIBACN SIDESETbAGK PL�NCIIECNNUMBER PI�Nd�ECNiEE <br /> FEE fiECEIPt NO <br /> USEZGNE IOTARE� y�C�NT51tE — <br /> pYES GNO FEES V�LU�TION FEE t <br /> 1YPE OF CONST. OLCUV�NCY GFOUP NOAF DWELLINO UNI1S �lil <br /> 512EOiBLDO. NO.OFSTOPIES M�XOCC.LO�O BWLU!NG 5 <br /> PLUMBING <br /> MECNANICAL <br /> FIFE SPpINKLERS REOUIRED ❑ VES ❑NO <br /> OTHER <br /> PEN�LTV <br /> •PPIiC���ON�CCBY PlANSCNECNEDBV AVV0.FORISSWNCEBY — <br /> TO1AL <br />