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� '�.PPLICATION FO`..f ���.� <br /> ! p a"'°'"" CONSTRUCTION <br /> � everett PERMIT e <br /> BUILDING DEPARTMENT <br /> 259•8745 TO BE COMPLETED IN INK- PLEASE PRINT <br /> i <br /> ! [� DEMOLITION �COMBINATION ❑ BUILDING ❑ MECHANICAL O PLUMBING ❑ $�aN <br /> � } NER M�IL�DOPE99 G tY 2 P FNONE <br /> :� `; ,v�„� /� ��q n6s-Z � S�c0.5 C�C P/nc.c SC S�voGch.,'sl �.t�• �3�1• 5�000 <br /> � �RC REC�OPDE �ONEN MI.IL�UOPC99 LfV ]IP PIIONE <br /> 1 <br /> ' XOENER�LCONiR�L10R <br /> M�II�DO�E55 pfv ]IP P1�ONE UCENSE• <br /> ���hvr'D A(',C�CR <br /> MECM�MUL LONiN1CtOq M��L�OORE55 Cllv liP PIIONF. LiCEN4E� <br /> bK11M��HOCONiR�G10H � Mut�OORESS CiIV ZIP P��OHE L�CENSE• <br /> 1 <br /> � <br /> ' L� OF WORIt <br /> �� NEW ❑ ADDITION ❑ AL7ERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDINO RELOCATION <br /> r � <br /> ,{ u�noeorwonK�costorr+�tcnu�sviusueoui t2�jS� . <br /> ; �'.c,�u,o.c, et� �nnar <br /> 5 �[lCRi\E WORIc ' <br /> � �\ ,S •N O <br /> "y �����'� I HEREBY CEFTIFY THAT I HAVE READ AND E%AMINED THIS AR <br /> PLICATION AND KNOW TH E SAME TO BE TRUE AND CORRECT.ALL <br /> : �EO�IDESC T�ONOFPROPEFfV19H0 BELOWOH�TT�CNfOUHGOPlE91 PROVISIONSOFIAWSANDORDINANCE300VERNINOTHI3TYPE <br /> ' 4 S�A i /.f_�— OF WORK WILL BE COMPLETED WITH WHETHS�SPECIFIED HERE• <br /> �ot�e�a,�yC—o< <� INORNOT.THEGRANTINGOFAPERMITDQESNOTPREBUMETO <br /> 61VE AUTHORITV TO VIOLATE OR CANCEL THE PROVISION9 OK � <br /> rR�tt-r G ANYOTHER5TATEORLOCALIAWREQULATINQCON3TRUCTION <br /> OR THE PEFFORMANCE OF CON£TRUCTION. <br /> SION�TUPEO�CONfR�CTORORAUTNORI2ED�GENT OATES —�FfG <br /> I <br /> 1 <br /> �VPLiC� SC YBU E55 CENS <br /> �,�JECi�DORES3 <br /> J`��3 �G�rl /. <br /> ' �LYM�INO MECHANICl1l <br /> '� Np, T'►[Of FI%NRE FEE NO. TYPE OF EOUIPMENT f[! <br /> � WATERCLOSET TOILE7) �IRCOND.UNITS—M.P.EA <br /> � FEFRIGERATION UNITS—H.P.EA <br /> ' 8I1iHTUB <br /> � L�VATORV WA9H BASIN BOILERS—M.P.EA. <br /> �i SNOWER O�S FIRED AC.UNITS—TONN�GE EA <br /> NITCHEN SIHK 6 DISP. FORCED�IR S�STEMS—B.T.U. M EA. <br /> ; DISMWASHER WALL NEATERS—B.T.U. M <br /> �i LAUNORV TR�V UNIT MEATERS—B.T.U. M <br /> �� CLOTNE$W�SHER EVAPOMTIVE COOlERS <br /> WATER HEATER CLOTHES DRYERS <br /> I URINAL VENTILATION FAN <br /> pRINNINO FOUN7AIN RANGE MOOD <br /> AIR MANDLIN�UNIT— C.F.M. <br /> �} FLOOR DRMN <br /> .: VACUUM BRE�KERS STOVE <br /> .j ROOF OM�NB—RAINLE�DERS MET�L FIREPLACE 6 CHIMNEV <br /> ' $INK SERVICE—BAR E7C. WOODSiOVE/FIREPUCE�NSERT <br /> ., <br /> `I <br /> � SUBTOTAL � <br /> SUBTOTAL <br /> � iEI1MIT t VERMIT f <br /> � T0TI1L FEE f TOTAL FEE � <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> PL�N GMECN NUMB[R pUN CHECK FEE <br /> fpONTSETB�CN RE�RSEIOAGN SiDESEfBACK pECEIPTNO <br /> FEE <br /> USEIONE LOi�PEA y��ANT511E FEES V�IU�TION FEE <br /> OYES ONO <br /> TYPEOFCOMST. OCCUPANGVGROUP NOOiOWELUN0UN1i5 <br /> BUILDIN6 f �� <br /> 8i2E Oi BLD6 NO OF S10RIE5 M�%.00G lOAO � �O <br /> PLUM9ING <br /> MECMr1NICAL Z � <br /> FIRE SPRINKLERS�7EOUIREO ❑ YES ❑ NO oinER <br /> � PENPLiV <br /> ? �PGUC�iION�CC.BY PL�N9CNECNE06Y �PFN,fORI55U�NCEOV �^� � <br /> TOUL �I <br /> ' �., _ G. <br /> '�� ��-l�Zu�Lt- 6� PE�—A/1 a r �! Z�a� <br /> , <br />