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- .-, <br /> . .PPI.ICATION FO. . <br /> '°'`"��"� C(J�NSTRUCTION `�`�`�`," <br /> �,n oF <br /> everett PERMIT <br /> BUILDING DEPARTMENT <br /> 259�87a5 TO BE COMPLETED IN INK• PLEASE PRINT <br /> ❑ DEMOLITION O COMBINATION �BUILDING U MECHANICAL ❑ PLUMBING ❑ SIGN <br /> vvflcn +�+n.noue�s ❑rv ziv w�or+� <br /> l �1�7��� r <br /> ��J_�y���� �- '��'sL-,� � D, tx����;>�l� tuF,A 1 / c'f�''��.� �s2 �/� 2 3 <br /> .a�i o�ocsic [�� � M•n.no�+ias cin zn• vHONc <br /> �./l/ I�r S �SS�Ci.q-�� . <br /> GI NIF�LC NfR�C10R MAIL A'iDli[55 CIfV LP PMON[ LICE115E• <br /> � ,�`.,:7ZdC 7c!�.i /�,l,? 9:%, lti-�7a,k,.1 L-Uc %`�� o� �5"7- 5�J 7-3 A��o�N <br /> ML .NI�MUL CONIP�Ct�A M��I.AD�RESS CIIY Z�� PIION[ UCCNSf.• <br /> PIVMB�N.CONIP�[.iON N�ilt.pDRC55 GIiY IIP VIIONC LICCNSC• <br /> cussoi wna. <br /> � NEW ❑ ADDITION ❑ AL7ERA710N ❑ REPAIR ❑ DEMOLITIGN ❑ WOODSiOVE/FRPL.INSER7 ❑ BUILDING RELOCATION <br /> \4lU�LON01'WOBe1CO5i01bAlCliiAL5CLl51A00l0 [s/ <br /> �-� 9.�f.�-'- ��.. <br /> nsct+�n[�voeK � _ , r <br /> �f � <br /> �iE Y__ .- {"rYi.�i L �� l.D'��>72i/c.�l:>/� , <br /> uae or ewi nwc <br /> �' 7 - I HEREBY CERfIFY THAT I HAVE READ AND EXAMINED THIS AP� <br /> �I,t !/.I C L��i'i'7• � ,� SiiJ't S� PLICATIONANDKNOWTHESAMETOBETRUEANOCORRF.CT.ALL <br /> �ecaocscair io�uvrnoacnrrispowaaeiou�or+.**.cNrouncor�rsi PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> —� S!��'L~- �'�� ��� �s NFORNOLTHEGRANT1NG0 AP'ERMITDOES OTPRESUMETO <br /> tOi PIOCK—Oc_�y,= 1 I� <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCT�ON. <br /> SIGNAiUR@Of'COMPAQCAORA I/ORRED4GENi DATE <br /> x — _ � (�. N- 17-8� <br /> . �c- <br /> PROJCCi�DDRE55 AP�UC NTSCI�YB�SINESSLiL[ISENO <br /> /�(QQTi l�l �Z. <br /> PI.UMBING MECNANICAL <br /> NO. T'PE OF FI%TURE FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET�TOILEn � UU AIR COND. UNIiS—M.P. EA. <br /> BATHTUB I PEPRIGERATION UNITS—H.1.EA. __�_ <br /> LAVATORYIWASH BASIN� BOILER$—MP.EA � <br /> SHOWER GAS FIRLD AC.UNITS—TONNAGE EA <br /> � KITCMEN SINN 8 DISP_ (� FORCGD AIR S�'STEMS—B.T.U. M EA O � <br /> _f DISNWASMER U 14ALLHEATERS—B.i.LL N <br /> LAUNDFVTRAV UO UNITHEFTERS—B.T.0 M <br /> � SHER Q�J EVAPORATN[COOLFAS <br /> m�TFG NFEiFO CLOTHES ORYf:f15 � <br /> URINAL �'ENTILATION FAN � <br /> DRINKING FOUNTAIN I RANG[l/OOD _ __ �O O <br /> FLOORDRAIN � 41RNANDLINGUNIT— QF.M. <br /> VACUUM BREAKERS STOV[ <br /> ROOF DRAINS—RAINLEADERS METAL FlREPLACEBCHIMNEV <br /> SINK SERVICE—BAp,ETC. WOOLSTOVE/FIREPLACE INSERT <br /> - H�'[�J2. <br /> SUB TOTAL Zd O SUB TOTAL S � JV <br /> PERMIT S PERMIT S <br /> TOTAL FEE f O C.�C� TOTAL FEE f y_�� <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> RO/4-1 SELpeLe �` RE»SCiOe�K SID[SEL[IFCK �'UN C��ECK NUMpLR PUN CMEGN(EE <br /> �.7 . .� � U._ . �) f[[ i��.IL�. �.�'� R2HPLN0<��G'� / <br /> oti! ZON[ LOLARE�� , ��� / <br /> WC�NiSiTE FEEB VALUATION FEEJ-�j j <br /> �� _ � -�J �j��' �- OYES f]NO <br /> *vv[OfLON51 OCCUP�NCYGROUP NOOFOWELLIYGUNRS ��-�r <br /> �,V R-3 I BIIILDING � ,� (op � <br /> S12E O�BIOG NO O�SiOF1E5 MAs OCC lOa� <br /> � , . "� �, N.Ai PLUMBING �� � <br /> MECMRNICAL (�� .'� <br /> FIRE SPRINKLERS REOUIRt^ ❑VES NO � <br /> OTNER I`/-. ; '� <br /> ��� <br /> PHNFLTY �7�. �'���,• <br /> eop�i�ROONACf. 9Y VUNSCHELI(E�BY APVRFORISSUANGE�V --- — <br /> � / <br /> TOTAL _ ,�,� .� ((��� <br /> SN ��, l_._ 'G • <br /> , <br /> - -�-- �- --- <br />