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A. PLICATION FOR <br />'"'E"ro'"" CONSTRUCTION <br />GIT'I OF <br />everett PERMIT <br />�UILDING D[PARTMENT <br />259-8745 TO BE COMPLETED IN INK - PLEASE PRINT <br />n ncuni �nnu n COMBINATION ILl•BUILDING ❑ MECNANICAL ❑ PLUMBING <br />❑ SIGN <br />�,c� od r C�rr.-(- <br />aiH���u cnr�rn�nrn� M�u annat„ nrv nr rnon[ uc[r�se r <br />l o�de �-+r� ��c � 5"b-3� i/ i �'�.,�dr.r� L. K s'�:�.t�:�s �8?f-r »°f'-%�c z iJ�,��.s� v�ay[ <br />..__......... �,..,....�.nn M�R ADONlS.. f 1\ bP PI�ONC I iCENSf. • <br />PIUM6�N �CONIP�f.iON AI�R �D[ (iC5$ f.iiV IIV PIIDNI IICENSC • <br />CLAS50� WORK <br />[1�q�W ❑ A001110N ❑ ALTERATtON ❑ REPAIR ❑ �LMOLIiION ❑ WOOI1S70VE/FRPLJNSERT BUILDING RELOCATION <br />v�iunioH or wonn �cost or M+tcnut s rivs �.�eon, <br />L� C' Q., aJ�`.j b o�� . <br />�ESCH�BC OPn � <br />> >J Y Y!, Y � � � /A-C'IFC �� <br />�i if-'C �1-,$' G <br />� , <br />�� <br />OWN O[I O W OR �iuu� r oo�� w <br />F L�� r � 3.� �. <br />�)LaTS ,� <br />z v� p'L n. r- „ <br />i<C,� _ <br />� <br />_ L� j <br />I HEREBY CERiIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />PLICATION AND KNOW THE SAME TO BE TRUEANDCORRECT. AL,. <br />PROVISIONSOF IAWSAND ORDINANCES GOVERNINGTHISTVPE <br />OF WORK WIIL BE COMPIETED WITM WHETHER SPECIFIEO HERE• <br />IN OR NOT. THE GRANTING OF A PERMIT DOE9 NOT PHESUME TO <br />GIVE AUTHORITY TO VIOLATE OF CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OP LOCAL LAW REGULATING CONSTRUCTION <br />OR TfiE PERFOHMANCE OF CONSTRUCTION. <br />SIGN4IIIIIh U1 f.ONIIlAC10R OH AU111UI111L1) �GLNI IIAI6 <br />X . i� ��C<,-� �'� '��tl-�c:, ��'� / / -�✓ <br />erri icu�rs r.nr ouso¢ss uc[r�s[ r,n <br />Np, iYPE OF EOUIPME <br />RIR COND I1NIT5-H P EA. <br />REfNIGERA710P1 UNITS=�� N EA <br />"__ f3011ER5_IIP EA ""_ __ <br />fORf.[D AIR SYSTEMS-d T U M EA <br />WAI.LIIEATERS-BT.U. M ___"'_ <br />UNI711EATERS-DiU __61 _"__"__ <br />— _ ___'_.____'—"---c11wTOLL "—.—� <br />P[XMII • — — s <br />--- ---'--- � TOT�L FEE <br />TOTIII.FEE _ ____'_} _'___ -- <br />_-____ __.__'.___'___-_-' <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />n[eiv sno•eK <br />101 �fiO / <br />occur+r� ��0� <br />_, r , <br />Ho ar stoniEs <br />� <br />BY <br />\ - <br />..a� r— <br />� ' <br />�.�.�, ,,,� <br />��ris Nyu <br />Ho or nw[� i mc uHire <br />reax occ � o<n <br />� APPR fOR �SSWNCE Ov <br />..! � �. � <br />f. ( 4. <br />��___�� G� �h �il� <br />FEEB <br />liUIlUIN6 <br />Pt UMBING <br />MLGIIRNICAL <br />OiHEP ��/ It 1/'1 / � I <br />S.il_I_��..y� <br />�ri <br />TOTAI <br />r� nN a¢cn r �c <br />„� , , t,��' H���,,., „� � ��3 <br />VI�L �TIOH FEE --- <br />E�, �i1) I�I�IC� <br />I <br />