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� � i <br /> APPLICATION fOR ���,�„ I <br /> '".`",°'"" CONSTRUCTION 0 <br /> �,n o, j <br /> everett PERMIT ; <br /> BUILDIN� DEPARTMENT ' <br /> 269-8810 TO BE COMPLETED IN INK• PLEASE PRINT , <br /> ❑ OEMOLITION O COMBINATION �BUILDINa ❑ MECHANICAL ❑ PLUMBIN(3 ❑910N � <br />� OWNER M�IL��ORESS CIIY IiP PNONE , <br /> pyoG��lg 3a.3 w, cnsiNo Rn. Gvc�ri�Tr � 9Ecoc�. : <br /> �PCNi1ECfOPDE��ONE11 M�i1�0011ES4 LiIY !�P PNONE I <br /> JnNu GRAHAh� �. AfSeC, k <br /> OENEMIGONTR�CI00 M�I1�00 ES9 Ci�Y 7iP PPONE IICENSE• <br /> �� l � , !7p•�u1C�°I`10 Se�-�2 1,c�11�i81c� S� I.LT F� ��allo <br /> MEf.11�NH:�tGONIR�f.tO M�¢�0011ES9 C�IY liP PIIONE UGFNbE• <br /> VIUMlINOCONTR�GION M�IL�00lIES9 GIY tiP PiIONE llCt11lE� <br /> i <br /> CUl70f WONN I <br /> � NEW ❑ ADDITION ❑ ALTENATION ❑ REPAIR ❑ OEMOLITION ❑ WOOUSTOVE/FRPL.INSERT ❑ BUILDIN� RELOCATION i <br /> W l W TION Of WONN�fA4i Of M1IEp��LS PL W I�BOHI ` <br /> � r.. <br /> ecnie[xron. <br /> ►,{�f�J 4GN1'�{l. UT�L� �1N �Aul� U�'ILIN TvNNC�,S <br /> uee aoiNo I HEHEBV CERTIFV TNAT I HAVE READ AND E%AMINED TN18 AP• <br /> ��v� • , �'�L��� �W6� PIICAiIONANDKNOWTHESAMETOBETNUEANDCORRECT.ALI <br /> LEO�LO[lLMM�iONO�oROPENtY1lNOWNBELOWMt1I1�LIlIIXIPLOP1Efl1 PROVISIONSOFLAWSANDORDINANCE9QOVENNINOTHISTVPE <br /> OF WORK WILL BE COMPLETED WITH WHETHERSPECIFIED HEHE• <br /> io�—s�ocK—or IN OR NOT.THE 6RANTINO OF A PERMIT DOES NOT PREBUME TO <br /> GIVE AUTHORITV TO VIOLATE OR CANCEL THE PHOVISIONS OF <br /> x� ��A��,��D ANVOTHERSTATEORLOCALLAWHEOULATINOCON9TRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. I <br /> SION�IUNEOiCONIN�QOR011�UT IZEDAOENi b�tE �. <br /> � <br /> X e� � <br /> VIIOJ[CT�DORElS �PPLIf.�HIB ISSI .fH3 NO 4 <br /> ��� {/�. �l/ /O �� , � <br /> •IUTA�INO MECHANICAL <br /> NO. TYK M FIXTUII[OII ITEM F!E NO. TYPE OFlOUIPMENT fL! ' <br /> WATER CIOSET�TOILEQ MC—NMNDLO UNITS—N V <br /> MITNTUO REfR10EHAT10N UNITS—N P EA. i <br />' LAVATORYIWABIIBASINI BOILERS—B.iU/HP i <br /> ���R OA9 FIRED 11 C.UNIT9—BS.LL � <br /> KITCHEN OINK�DIOP. FORCED�IN SYSTEM9—B T.U. M EA. i <br /> p���p W�LLNEAIER9—B.T.U. M <br /> LAUNORY TRAV UNIT HEATERS—B.T.U. M � <br /> CIOTHE9 W�BMER EVAGORATIVE COOLEHS � <br /> ��N�� CLOTNESORYERS � <br /> pMNNINO fOUNTAIN VENTIlAT10N FAN � <br />' fLOOR OMIN MNUE HO00 <br />� lACNFLOW PNEVENTERS W�TER HEATER '� 4 <br /> IIOOF ORIIINS—RAIlIIEADERS WOOD STOVE <br /> 61NK�lERVICE—BAR.ETC� METAL fIREPLACE t CHIMNEY � <br />� FIPEPUCE INSERT f <br /> HEAT PUMP <br /> OAS VIPINO <br /> E%HAUSTFAN � <br /> ! <br /> �U�TOTAL t �U�TOTAL � <br /> r[IIMIT { /OIAMT �. <br /> TOTAL/�� � TOTAL R! <br /> �AONry[IQCK ME�N9E�B� 810EDEf� /�NCM a3�o 1 FE�� pE„JPp�(j/D r <br /> �" (� 4 <br /> uc[tox[ �Of�REA vc�Nr s�a FEES VALUATION fE[ � <br /> s <br /> OYE O • <br /> eu��o�r+a s o0 000 ' <br /> TYP 0 GONlf OCCUP�NCYG110UP NOO OWEllIN0UN114 � <br /> � _� �— � PLUMBINO <br /> 54E Oi B100 NO O�110PIE! M�Y OGL 10�0 MECNANICAL ' <br /> M-oU4 r �� <br /> OTHER � C (C i <br /> FIRE SPRINNlER9 REOUIRED O YES !(NO gTAfE BUILDINO SUHCNAR6E <br /> l STATEENERGVSUNCHAROE <br /> �VVlIE�110N�CCBY PIANSCIE6Nj� ��P� fOf1�9511�NCEBY pUBLICWORN9 <br /> /D � TOTAI <br /> PfiOPERTVOWNER9ARERE9PON810LEFORDETEPMI NO LL� <br /> PROPER�Y LINE LOCA710N6AND REUiED EA9EIAENTB. <br />