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,: ,,,.E .,o,,,� � �PP LICAT IO N F0.1 ���,�„ <br /> . GIT'OF CONSTRUCTION O <br /> everett PERMIT <br /> BUILDING DEPARTMENT <br /> 259-8745 TO BE COMPLETED IN INK- PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUM8ING �'SIGN <br /> , OW�'�//� ���//V//�G71lADDRES�/// rM/Ti�STI �ii�Va+•/ lVy/' C� "W/NE (/���"/ YY <br /> ♦qAl11CLIONU[SIGNEf1 MlAODR[55 CIiY 21P PIIONE <br /> � G�4 �/�"/ ✓���/ll� Mel �p//V� /0/(/ Cliv�� ���`�V LlL �O�VVOYJ /✓•!� /Vl�� <br /> MECII�NIULL0111R�CIOfl M�IL�DDRE55 Lltt bF PNON[ LICENSE• <br /> • PlUM01NGLON6U�l01i M�ILAODA[SS CIiV 21P PIIOHE IICENSE• <br /> � CUSSOF WORN,�,� <br /> � ❑ NEW LK ADDI710N ❑ ALiERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODS70VE/FRPL.INSERT ❑ BUILDING RELOCATION <br /> ' V�LU J�1Y0!�N�CpS/i,L.'M�iERi1LSPW5L�BOB1 <br /> G�� UV <br /> � <br /> OESCniO[w0��rc <br /> irv�rr�r� Cxs'i�c�nz ��� oN � nrv �" t� <br /> use emie9irv�e�/ f' ' .� I HEREBY CERTIFY THAT 1 HAVE READ AND E%AMINED THIS AP- <br /> � !�f/fi�i1/�I / �LI• PUCATIONANDKNOWfHESAMETOBETRUEANDCORFECT,ALI <br /> LEO�LOESCNPIiONOFPPOP[11tY�5NOWNBELOWOq�tT�LMfOUFGO�IES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED FiERE• <br /> io�—e�ocK_or— IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANVOTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIGNATURE OF CONiRRCTOR OR Rl1TMORIZEO FGEN7 ORTE <br /> "' !( / ' � �y VC/ <br /> • PROJEC1App�E55 �PPLIC� ❑YBUSINESSLIG ENO. <br /> ���� �i�>iy�� �r. ��u�r <br /> � PLU!0BIN0 MECNANICAL <br /> - MO. TYPE OF FI%TURE FEE NO. TYPE OF EOUIPMENT FEE <br /> � WATERCLOSET�TOILET) A�RCOND. UNIT$–H.P.EA. <br /> BATHTUB REFRIGERATION UNITS–M.P.EA. <br /> � LAVATORY�WASHBASIN� BOILERS–H.P.EA. <br /> SHOWER GAS FIRED AC.UNITS–TONNAGE EA. <br /> KIICHEN SINK 6 DISP. FORLED AIR SYSIEMS–B.i.U. M EA. <br /> OISHWASHER WALLMEAiERS–BT.U. M <br /> LAUNDRV TRAV UNIT HEAiEF$–B.T.U. A'. <br /> � CLOTHES WASIIER EVAPORATIVE COOLERS <br /> �. WATER HEATER CLOTHESDRVERS <br /> URINAL VENTILA�ION FAN <br /> DRINKING FOUNTAIN HANGE HOOD <br /> ' FLOOR DRAIN AIF HANDLING UNIT– QF.M. _ <br /> VACUUM BREANERS STOVE <br /> FOOF DI7AIN5–RAINLEADERS METAL FlREPLACE 8 CNIMNEV <br /> SINKISERVICE-6AR,ETC. WOODSTOVE/FIREPLACEINSERT _ <br /> � SUBTJTAL SUBTOTAL S <br /> � PERMIT f PERMIT f <br /> ' TOTALFEE t TOTALFEE 3 <br /> ' THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> lROHf5E1B�CN R[ANSE1pRGN SIpE5E1B�CN PLANCNEGNNVMBER PLANLIIF.CKfEE <br /> - fEE RECEiPi ND <br /> ' USE ZONE lOi ME� ypCAt:i SAE <br /> FEES V11L111TION �EE <br /> pYES �NO — <br /> fYPCOlCONSL. OCCUPANGYGROUP NOAFOWEILINGUN115 <br /> BUILUING S <br /> SIZE OF�1D0 NO OL SIORIES MAX OCQ LOPO <br /> PLUTABING <br /> MECIIANICAL <br /> fIRE SPRINHLERS REOUIRED ❑VES ❑NO <br /> OTMER <br /> PENRLTY <br /> �VPLICAIION�CC BY PLANSGHEGNE09Y �PP0.FORISSU�NCEi� -- <br /> TOTAL <br /> v �F�a-�-�r2E �rwc� <br /> ��SI�C� Stz� Tc7 'P�- <br /> �r�tz�o pQco� <br />