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^ � <br /> � APPLICATION FOR �,�,�„ <br /> '".E"'°'"" CONSTRUCTION e <br /> CIT`I OF <br /> everett PERMIT <br /> BUILDING DEPARTMENT <br /> 259•8�45 TO BE COMPLETED IN INK• PLEASE PRINT <br /> ❑ DEMOLITION �] COMBINATION ❑ BUILDING GT�VIECHANICAL 19 PLUMBING ❑ SIGN <br /> OWNCR M�ILADpRE59, GITY 21P _ CHONE <br /> �,��n�hlnC�i���l C'e�KtiS ��-r. C'T�_ . ��-irc OaKt.� r�cF. r� ��- ��3�r—��cc� <br /> ��CNIfEt10ROE5�ONEH M��L�DDHE53 GIfY 21P PIIONE <br /> RENEP�ILONiR�C10R M1ILAOORE59 C�1Y ZIP PNONE 4CENSE• <br /> MFC111119C�1 CONfR�GiOR M�I1.1100RE55 CI1Y ZIV PNONE L�CEHSE• � <br /> T�1All(1'Al ' 'r1S [_��l'�ll� C�'. ilna5 �.Y\A���1� l.'�4u1I�I?. � l: Vr r��J�S �c�L��� <br /> FIUMB�N�CONIRAGfOR /'111A0DRE9S CITY 2�F PIIDNE I�GE..SE• <br /> N ta7 r.l['L<F� " Iv�1' �c <br /> a.ss or wonK <br /> ❑ NEW ❑ ADDItION �/ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVEIFRPL.INSERT ❑ BUIIDING RELOCATION <br /> ��W�f10N Of WORN ICOST O�M�IERi0.5 PLUS L�BOPo <br /> OFSCNIBE WO R • <br /> i n:����1 '� , �n������.�c�. �`�c�-��,�, �,f��Ca-� 2__� <br /> use or eu�iou+a I HEREBY CERTIFY THAT I HAVE REAU AND EXAMINED THIS AP- <br /> k?.�'T \((,L'���\E11T C �112:�— PUCATIONANDKNOWTHESAMETOBETRUEANDCORfiECT.ALL <br /> «O�l0E5CRiPIIONUFPPOFE111Y�9HOWNBELOWO11�iT�CNFWRGOP1E51 PROVISIONSOFLAWSANOORDINANCES60VERNINGTHISTVPE <br /> . OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br /> io�—e�oc�—or IN OR NOT.THE GRANTING OF A PERMI?DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REG ULATING CONSTRUCTION <br /> — OR THE PERFORMANCE OF CONSTRUCTION. <br /> 516NAiUi7E OF CONTR�CTOR OR�UTNOHI2ED AGENT OAiE <br /> X � = � (:_� �� C �� �. _ <br /> PROJECI �ODRE9! �1PPLIC� i9CITYBl151NES9lIGEN5EN0. <br /> � ����� / <br /> �rT�`_. �7�7 O ? <br /> VLUM INO MECHANICIIL _ <br /> � NO. TYOE OF FIIfTURE FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET ITOILEII AIR COND.UNIiS—H.P.U. <br /> BATMTUB REFRIGER�TION UNITS—H.P.EA. _ <br /> UVAiORV�WASH BASINI BOILERS—H.P.EA _ <br /> SNOWEN ORS FIAED AC.UNITS-70NNAOE EA ___ <br /> NITCMEN SINK 6 DISP. FORCED AIR SYSTEMS—B.T.U. M ER. <br /> OISHWASHER WALLHERTERS—B.T.U. M _ _ _ <br /> UUN�AY TPAV UNIT HEATERS—B.T.U. M _ _ <br /> CLOTHES W�SHER EVI1POfUTIVE COOLERS ___ <br /> W�TER HEATER CLOTHES DRVERS __ _— <br /> � URIN�L VENTIL�TION FAN _ <br /> ORINKINO FOUNTAIN R�NOE HOOD <br /> FLOOR ORAIN AIR HANDLIN6 UNIT— G.F.M. _ _ <br /> V�CUUM PREANERS STO`lE — -- <br /> ROOF DRRIN3—PRINLE110ER5 METAL FIREPLACE 8 CHIMNEV <br /> SINK SERYICE—BAR,EtC. WOODSTOVE/FIREPLACE INSERT __ <br /> .— '___ '_'.'.'___ .. __ _.. <br /> SUB TOtAI S5 00 SUB TOTAL s _ _ <br /> � PERMI� � I O PERMIT S <br /> TOTAIFEE • TOTALFEE s _ <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> tqONf5EI0�CN �E�NSEiOACN SIOESETB�eK PL�N�HEGKNUM9ER PUNGNfGKFEE <br /> fEE aECEIPT NO <br /> VSE 20NE LOf�OEl1 y�C�NT SIiE FfE! V�LUIITION F!! <br /> OYES ONO <br /> IYPf.OfCON51 OCCUMNCVGIIOUP NO.OFDWELlINOUNiT3 — <br /> BUILDINQ s <br /> SR[OI BI.I10 NO OI SIORIE9 MA%.00C.IO�D <br /> PLUMBIN6 <br /> MECHANICRL <br /> FlPE SPRINKLENS REOUIRED ❑VES O NO Ot��EF <br /> PENALTY _ <br /> �I'PIIUtION�CC BY i'I�NS G1IELNED BY APP0.fOR ISSUANCE BY <br /> TOT�L <br />