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i"�CPPLICATION FO���' <br /> Ms Er�rprsen GO N ST R U CT 1 O N ��� <br /> C�n OF <br /> everett PERMIT <br /> BUI�DING DEPARTMENT <br /> 2,9�8745 TO BE COMP�ETED IN INK• PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION �BUILDING ❑ MECHANICAL O PLUMBING ❑ SIGN <br /> owrn.n Mni�nuon[ss cnr zir o��oric — <br /> 11•M. G,�.xo,:� ��d� ��. �tiU�o �1Z . ���-�- �� 3 2�a Sa�3 <br /> ♦IIO�ItCC10RD[SnbNEO MRILRDOf1E55 CIiY IIP P�IONE <br /> / �'�Y olf�KF57�1'.A.✓ .��8 a+�c-o�aa.�' ��. ��=a7err l`F�2CU 3 o7�T o7- ��3X <br /> GGnCnAL CO�tlP�C10R �UIL�D�RE55 ��n' Z�� ���Opf UC[NSE• <br /> �L�.r�a0 ��l�S'.{=C-'3Z _ <br /> MLf„IIqNIC4lGONIR�L10fI MAI��ODR[$5 CIIY tIP f910NE IILENSE• <br /> PLUMBINOCON:R4CiOR M�ILRUURE55 CILY ZIP PIIONE LICENSE• <br /> C1�5501 WOnN�,1 <br /> ❑ NEW ,r.a �DDITION ❑ ALTERATION ❑ REPAIR I� DEMOLITION ❑ WOODSTOVE/FRPL.INSERi ❑ BJILDING RELOCAIION <br /> v��un �v+orwonKmostorninicninisr�usuBoni <br /> ��Z�Q� <br /> ursc�uec�.onn <br /> /�tl�1 1%y�Xl6"� �l'� '-Z Use= <br /> usr or owiUiHa I HEREBV CERTIFY THAT I HAVE READ AMD ExAMINED THIS AP• <br /> ����'�'u>1 PLICATION AND KNOW THE SAME TO BE TRUE ANDCORRECT.ALL <br /> im��o[scnmuor+oFrnnrennisrwwHouowon�n�eNFouneomes� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPE <br /> �� . r.�� �•� _� ;� „ .. t_�� OF WORK WILL BE COMPLETED WITH N'HETHEHSPECIFIED HERE- <br /> iorl_1�oiocn��_or - INORNOT.THEGRANTINGOFAPERMITDOESNOTPRESUMETO <br /> GIVE AUiHORITY TO VIOLATE OR CANC:.L THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIGNAIUREOFWNifIRGiORO THOPIiEDhGENT 047E <br /> . X � �' Y���'-1�8'F <br /> PROJCG1�OOf1E55 APPLIG BCIlYBU51N[SSLIGENSEND <br /> /�f�2 S— �C'v�-I<c�z <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI1fTUNE FEE NO. TYPE OF EOUIPMENT FEE <br /> WAIER ClOSEi�TOILEn AIRCOND.UNiTS–lI.P.EA. <br /> BA7H7U0 REPRIG[RATIJN UNIiS–H.P.EA. _ <br /> LAVAtORV IWA511�ASIN� DOILERS–H P.EA. <br /> SIIOWER GAS FIRED AC.UNI75–TONNAGE [/. <br /> NITCHEN SiNK 6 DISP. FORCED AIR SY57EU5–B.T.U. M En. <br /> DISHWASHER WALLHEATERS–BT.U_ M <br /> LAUNDfiYTRAY UNITIIEAIERS–B.T.U. M <br /> _ CLOiHES WASHER I EVAPORA7IVE COMERS _ <br /> WAfERHEATER CLOTHESDRVERS _ <br /> U�II��L VGNIILATION FAk ' _ '— <br /> DRIIJNING FOUNT�IN FANGE IIOOD <br /> FLOOR DNAIN AIF HANDLING UNI7– C.F.M. _ <br /> VACUUM BREANEHS STOVE <br /> ROOF DPAINS–(7AINL[ADERS �IETAL FIREPLACE d C''���NEY _ <br /> SINK�SESVIC[–BAq,EIC. WOOOSTOVE/F'�REPLAt,L INSCF� i <br /> SUBTOTAL SUBTOTpL f <br /> PEFMIT S PERMIT S <br /> TOTAIFEE 3 TOTALFEE S _ <br /> THIS PORTIOPJ TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> ���UNISCIpACIt �iCNiti[fOALN SI�ESE1pRCK PLANCMEGNNUMO[P (_•�O PLANCNECNf[[ <br /> 2� Zo s �6 `�° � �E� 3a.s3 n[ccir��+o �9�53 <br /> USG tON[ lDl A/RCn y�CANt SIIE <br /> R�Z IpZO�O SF OYES xiNO FEES V�LU�TION fEE <br /> ITvfpff.ON,Sf/ OCCUPApCYG00UP NOAF�W[LLINOUNIiS <br /> �n �r� , �UIIDING S��'� � -rjZ7 <br /> SIZE Of lfLV6 ND Of SfORIES MAR.OCG.LOAp <br /> /�18 SC• / � PLUMOING <br /> ( / <br /> MECNANICAL <br /> �It7E SPfiINKLERS REOUIR[D O YES NO <br /> OTHER <br /> PENRLTY <br /> ni`PliCntiOH4�G Ov P�nrvSCM[CnE00Y RPPRiORI55UANGEBV -- <br /> TOTAL �D�� <br /> M-.M. J� G • G • - — <br />