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IneEverOreen `y�PP��CATION FO�� everell <br /> �,TYOF CONSTRUCTION O <br /> everett PERMIT <br /> TO BE COMPLETED IN BLACK INK— PLEn3E PRINT <br /> BUILDING DEPT. <br /> 259•8745 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> owr�[n Mu�nooncss cin zir m�oN[ <br /> Pverclt 6lnsonic Cori�. ]fill Everett Ave, Gverett, NA 98201 (LarrV Rntvie) (20G) 252-GG9G <br /> .n����i������nnrsiaNrn ��U - 108th AVe����:59 Suite 4U5� 13ClleVUq��1rA 98UU4 21p (206� 45�������55 <br /> h 13N&II 42U(i Ilovt Ave.. L•verett. LVA 982113 (20fi 259-08C,8 <br /> GLN[p4LGON1RA�lOq IARILR�OR[SS GIIV ZIP PIIONE IIGENSE� <br /> IJCCIIARICALCONfRAGiOfi MAILRDDRESS CIIY 21P PIIONE LICCNSE• <br /> Pl01Af11NGCON1MClOf1 MAILApOPE55 CILV ZIP PHONE LIC[NS[• <br /> C1A550F 1V011H <br /> � NE\N ❑ ADDITION ❑ ALTEPATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ �UIL�ING RELOCATION <br /> vniu>uor�or wonK�cosr ov unicnin�s r�us uoon� <br /> �11111,0UU.0U <br /> u[sc�ao[wonn <br /> Construction of a ]2 ft. x 28 Ct. L'oui ment Buildin and u 100 fl hi li Antenna. <br /> usc or awimr+o <br /> IClCI'SLIILC BIOb1IC hOt1C COIt1f11U0iCaliofl5 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> P PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL <br /> iccnio[sceimior+ornnorcntvlS�wwHocwwonnrtecnvouncoviesl pROVI510NSOFLAWSAN00RDiNAhCESGOVERNINGTHISTYPE <br /> ,ols 23, 2d, & S011lll Ilolf Of 25 , , OFWORKWILLBECOMPLETEDWITHWHETHEFiSPEC�FIEDHEFE• <br /> io�—awcl�.}�-or IN OR NOT.THE GRANlING OF A PERMIT DOES NOT PRESUME TO <br /> . GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIGIIATURE F ON CiOfi O�AUINORIZEU AGENi OAIE <br /> X � 5�/G �'S <br /> PpOJ[CtRODFE55 RPALICRN l IE 3 S[N0. <br /> 2G14 �Vetmore <br /> PLUMBIN6 M ANICAL <br /> NO. TYPE OF FI%TURE FEE NO. TYPE OF EOUIPMENT FEE <br /> WATEFi CLOSET�TOILE7) AIR COND.UNITS-N.P.EA. <br /> BA7HiUB REFRIGERATION UNI7S-M.P.EA. <br /> L4VATORY�WASH BASIN� BOILERS-H.P.EA. <br /> SIIOWER GAS FIRED AC.UNITS-TONNAGE[A <br /> NI7CHEN SINKB DISP. FORCE�AIR SYSTEMS-B.T.U. M EA. <br /> OISHWASHER WALLHEATERS-B.i.U. M <br /> IAUNDRYTRAY UNITH4AlER5-B.T.U. M <br /> CLOTHES WASHER EVAPORATNE COOLERS <br /> WNER HE�TGR CLOTHES DRVERS <br /> URINAL VENTILATION FAN <br /> OfiINKING fOUNTAIN RANGE HOOD <br /> PLOOR OR�IN AIR HANDLING UNIT- C.F.M. <br /> VACUUM�REANERS SiOVE <br /> ROOF DRAINS-RAINLE4DERS METAL FlREPLACE 8 CIIIMNEY _ <br /> SINN�SERVICE-BM,GiC. WOODSTOVUFIREPLACE INSEI7T _ <br /> SUATOTAL SUBTOTAL S <br /> PERMIT S PERMIT S <br /> TOIALFEE S TOTALFEE S _ <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> IROIlISC10nCH RCAIiSEIOACH SIOESEIORCN PLANGME NNOMBEB PLANCIIECNfLC <br /> .__'__ _ � �J � 7 E �3 r[e�� � nEC[�7(JO 7 <br /> usEzoNC lornn[n y�CANTSItE <br /> 7/ FEES YRIUAiION FEE <br /> /3- 3. J c�o oY�s zNo <br /> IVPCOf�f^,j0u51. / OLCUPPIlCYG�R/qUP NO.OFpWElLINOUNITS <br /> J(�' I!I/Z. fj-y� � BUILDING E��/(�.Qi (�. ` OO <br /> SIZE Of O100 HO Of SIORIES MRX.00C.lONO — <br /> 7 � SF / � PWMOING <br /> MECH�NIC4l <br /> FIRE SPRINKLERS REOUIRE� ❑YES NO ' <br /> OiHER <br /> PENALTV • <br /> 4PPLICR110N ACC.UY PLANS CIICCNEO BY RPPR.FOR ISSU�NCE BY -- <br /> TOTAL � DU <br /> �. (3 J�� L • � <br />