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. .PPLICATION F0.1 ��„�„ <br /> IMEnryrM� CONSTRUCTION O <br /> un os � <br /> everett PERMIT <br /> BUILDING DEPARTMEIJT <br /> 259•8745 TO BE COMPIETED IN INK• PLEASE PRINT <br /> ❑DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING �SIGN <br /> owN{cn ( MAIL�DOR/E5'�5 cm nP ar�oNc <br /> ^�'�/lO/ SGI'q XI/(Ll/ �MII�DOPE55�I� ��C� L���� 21V P�IONC <br /> fiGd <br /> GLNCP�ICON�R�G�OR M�IL�OOFE55 Gltt Ii �uONE LICENSE• <br /> Uc=,:izy N["c�u i uc ('� Brx 57.��i LYA.�ti�woor� `)d'eyd -s'�] 77v-fi��3� 13C�ri ti��t.tv�.w, <br /> MLCII�IIIULCONiRI�CiOH M�II��ORE55 • CIIV 21� PHONC UCCNS!• <br /> i'LUMB�N.CONIIUCIOR M�ILAODRE55 CIIV 21P FIION!" LICENSC• <br /> cussui wonK <br /> {� NEW ❑ ADDITIUN ❑ ALTERFTION ❑ REPAIR ❑ OEMOLITION ❑ WOODSTOVE/FRPL.INSER7 ❑ BUILDING RELOCAIION <br /> y,��u��iorv nr wann ir,o5i or�nertrunis rws uBon� <br /> A ' <br /> � ";4� `)S' <br /> m sr.me�.wonrc <br /> 7i�c, Lt �l) fYF (,'Xg� I'u.u�uun9t•i�_ I'�Qo�nNc- Si�� ��1) 3i[��SYF I�tu.�nu+i�1� u�Au SiG,�� <br /> �usr or nmi oiNc -'� -� <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> CObI�I FR�I A'L PLICATIONAND KNOW THF SA�dF TO BE TRUE ANDCORHECT.ALL <br /> ua�iorsCmm�oNo�vnorEn�risno.vHeEiowonenecNrouncori[si PROVIS!ONSOFLAWSANDORDINANCESGOVERNINGTHISIYPE <br /> OF WORK WILL BE COMPLETED WITH WHETl1ER SPECIFIED HEFE- <br /> io�_oiocrc--or IN OR NOT.THE GRANTIPIG O�A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CAPlCEL THE PROVISIONS OF <br /> ANV OTHER STATE OR LOCAL LAW REGULATING CONSiRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIGNATUR OFCONiR4C10ROfiAUiHOBl2[ORGEHf DAi[ <br /> X Vt;� 'rvt . � �y'86 <br /> r�no.aa�om�css �PPIIG�Ni'SQtY p115ME55ULEN5E YO <br /> a�i �`t ��c �� <br /> PLUMBIN6 MECHANICAI <br /> NO. TYPE OF FI%TURE FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET ITOILEn AIR COND.UNITS-NP,EA. _ �__ <br /> BAi11TUB REFRIGERATION UNITS-H.P.EA. _ _ _ <br /> lqVA10RY�WASH BASIN� BOILERS-H.P.EA. _ <br /> SNOWEP GAS FIPED AC.UNITS-TONNAGE EA _ <br /> KITCH«'SINN 6 OISP. FORCEO AIR SVSTEMS-B,T.U. M EA. _ <br /> OISNWASNER WALL HEATERS-B.T.U. M <br /> LAUNDHYTRAV UNITHEAiERS-B.T.U. M _ <br /> CLOTNES WASHER EVAPORATNECOOLERS _ <br /> WATER HEATER CLOTHES DRVERS _ <br /> URINAL VENTILATION FAN _ <br /> DRINKING FOUNTAIN RANGE HOOD _ <br /> FIOOR DHAIN AIN HANOLING UNIT- C.F M. _ ___ <br /> VACUUM BREAKEHS STOVE _ <br /> ROOFDRAINS-RAINLEADERS METALFIREPLACEBLHIMNEY __., <br /> SINN�SERVICE-�BAR,E7C. WOODSTOVE/FIREPLACE INS[RT ,_ _ __ <br /> Sl1B TOTAL SUB TOTAL f <br /> PERMIT f PEHMIT f <br /> TOTRIFEE f TOTALFEE S __ <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> 11�U1115LIp�Gk ��U115CIOALN SIOESEiBACN PL�NGNECI(NUMUER �UNCIi1Ltlf[E <br /> fEE ntC[���NO <br /> U51 NNL LOI�11U y�G�NI51iE <br /> OVES OHO FEES V�LU�TION �E� <br /> 1\i'f OI f.ON51 OCCUI'nNCYGBOUP NOOFOWELLINGUNIIS _ _ <br /> BUILOINO 5 J OO <br /> tiiti OI HIf�6 NU UI tiIOfUES MA%OLC.IOAp <br /> 1'l 11M111N� <br /> MECH4NICAL <br /> flRf:SPRINKLERS REOUIR[D ❑ YES ❑NO <br /> OTNER <br /> PENRLTY <br /> AI9`IIL��ION�I:f. OV PL4NSCI�ICk[DBV APPF.fORI55U/�IC 9Y '-- ---� <br /> �� � TOT�L <br /> c <br /> NI�K. J�IZOJti7�`�iJ B/- /G� /-T /?�U7- <br /> `' NC��- cLfJSL-YL r'���tl '�f-T 7'c.� <br /> � �CG OF Gc/,�/?� <br /> ��1• ��� <br />