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tir'�LICATION fOti ���,�„ <br /> '".`",,'"" CONSTRUCTION e <br /> �,ry oF <br /> everett PERMIT <br /> BUILDING DEPARTMENT <br /> 259�a�a5 TO BE COMFLETED IN INK • PLEASE PRINT <br /> ❑ DEMOLITION O COMBINATION 6/BUILDING il MECHANICAL ❑ PLUMBING ❑ SIGN <br /> ' Men .mm�.:;s <erv nr w�rn��: <br /> OWN[q C� <br /> r1►-�i= 'C G l- L i��� �n r.! d"1! �i u � T���E' '-<<:���J c=L�c<�r„•ry� 7c� 1 �•��oa � 9- � « <br /> ancrnncionn�smr+u� V ��+n �nnmss <br /> ctN[n�ico�+iA�non (� ��'�`�n +nun�ss cn rir ruovc ueense. <br /> Np2S'N SOu�c4l� ��l1V�� `7•r�->��S'f�to/,�er4 ���. 13LIA�� M 5t/�., 9j'�)0 G:i3a5l:! .}aHN5�1513LRH <br /> Mcu�.Hic•i coniaacrnn <br /> u�n.ennniss cnr ��r r�w�+e uecr+se. <br /> PIUMB�Nfi LOHfp�CtON <br /> �eu� AI)DRI55 CrtY ZIP PIIONE IICENSC• <br /> CL�55Of WAA� <br /> ❑ NEW ❑ ADCITION ❑ ALTERATION �REPAIR ❑ OEMOLI710N � ❑ WOODSTOVE/FRPLJNSERT BUILDING RELOCATION <br /> vu wno�or woar.�cost ov M+t[ni�i s riu,i�oau <br /> �Y�n O� - <br /> n[ nmc wouK (� � � � � / n �, J' <br /> ICC�� I�C Fnu�cY<1Ttc,�•� - I�P���L?CI�j LLLLC-li=a�r�L�_(�1-QL, — <br /> USF Of B11�LD�NG , I HL"RCOY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> �E;� ��Q�.�til �'-/�( PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL <br /> imao[scA�ouoHovrnorcnr�isr�owr+nnownnsnenuaunr.a�ics PROVISIONSOFL�WSANDOFDWANCESGOVERNINGTHISTYPE <br /> O�WORIC WILL BE COMPLETED WITIi WHETIIERSPECIFIEU HERE• <br /> ioi—eiocr`—or IN OH NOL THE GFANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUIHOAITY TO VIOLATE OR CANCEL THE PROVISIDI:S O� <br /> ANYOiH[H STa1E OR LOCAL LAW fiEGULATINGCONSTFUCTION <br /> OR THE PERFORfdANCE OF CONSTRUCTION. <br /> SIGNRIUN O!CU�1IIUf,IO110NAUT110RILL� G@NT Dh1E <br /> X�orc.r� f `�a.,,.,.��'� 4,-/�- F� <br /> erri�curts cnr ousu+ess i icuac r�o <br /> vaaeer�ooaess <br /> �R � 9 u �c Tc.�F2 6�1. �ve-2e'"T� <br /> MECH�NICAL <br /> PLUMlINO --- -- FEE <br /> NO. iVPE OF FIKTUPE _ FEE _NO. TYPE OF EOUIPMENT <br /> WATER LLOSET�TO�IE AIR COND UNI75-H P.[A <br /> REFRIGERA710N UNI7$-Ii.P EA <br /> BATMTUB -- -- <br /> UVATORYIWASM BASIW OOILERS-H P. EA — <br /> GAS FIRED P C UNITS-TONNAGE EA ___ <br /> SNOWEfl —— <br /> KITC1iEN SINK 8 OISP. _ FORCED A'A SYSTEMS-B.T.0 M EA <br /> - WAIL IIEATERS-0 T.U. M <br /> D�SHI4ASHEH <br /> LAUNDRV TRAV _ UNIT HEAiERS-B T.U. M __ <br /> LLOTHES WASHEH EVAPORATIVECOOL[RS <br /> WATER HEATER _ CLOTMESORVERS -- <br /> VENTILAIION FAN <br /> UFINRL <br /> DH�NKING FOUNTAIN ___ AANGE IIOOD _ -- <br /> pIR NANOIJNG llNli- C F M _� _ <br /> FLODR DRAIN -- ----'- <br /> VALUUM BREAKEF$ _ _ _ STOVE <br /> ROOFDRp�NS-RAINLEFDERS _ _ METALI'IREPIACEd CHIMNEV - <br /> SINK�SERVIGE-BAR ETC) _ WOODSTOVE/FIREPLPCEINSERT <br /> --- - --- - ' - SUB TOTAL s -- <br /> SUB TOT�I __ — -- — f <br /> PERMIT_ S -�'- __ ____ PERMIT <br /> -- - --- TOTl1l FEE s <br /> -__-__' _ <br /> TOT�LFEE s - -- '-----_ <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPl'. PERSONNEL <br /> PLAN GIIEGN NIIMUER PUN CHFCN F[E <br /> �qONt SC*fiA�M RE�R SETB�CK SiDE SElO�CK pF,LEi�i NO <br /> FE[ <br /> �--�� <br /> 115E 20NE 101 ARG vnG�lli SIiF FEEB v�LWT10N FEE __ <br /> i,rts ur+o — SG <br /> TVC[OfCONSi OCCl1P�NLYGROIIP NOOFOWEILINGl1��115 / - <br /> 13uIlDING s �1 (�J �� <br /> 512C OG BLDG HO Of STORI[5 AI�% OCG LO�O �- --{ <br /> PWMBIN6 <br /> MEGIIANICRI <br /> FIFE SPRINKLERS RE�UIREO ❑�ES ❑NO Ot11EF <br /> VLHALTY - <br /> APPI�f,Al10N�Cf, pY PUNSGNEGNEOBY �f'PR fJNi35URICEBY --�'— � C C�/�I <br /> iCiAL ___ -�J •�l/ <br /> �\p�\\\� -_. _ <br /> -_ '_-__ <br /> \"� . - -_ _ ___ - <br /> 1 <br /> I <br /> � <br />