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InaEvs�proen `f"�PPLICATIQi� FO�' evereN <br /> CIfYOF CONSTRUC�'ION � <br /> everett PE�MIT <br /> BUILDING DEPARTMEN7 <br /> 259-8745 TO BE COMPLETED IN INK- PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINPTION ❑ BUILDING O MECHANICAL ❑ PLUMBING ❑ S�GN <br /> oYmU� M�iL�0�PE55 CI1Y qp PMONE <br /> W D. No�✓e �� <br /> n11Cw1EGIONO[SiGNE11 M�R�DOPE99 Cltt ZIV vNONE <br /> 4lNC1uLCUNIBALIOq M�IIAJ�RE55 Cltt ZIP PI�ONE LIGENSE� <br /> � �F{ Co�s'�, 6� 23 2N3�" s •C• /T1onro� 99A�2 79y- GBNI <br /> '.11 UI�Nif,41.GONIORC10f1I 1 �f MNL AO�PESS CIiY 21P PHONE LICENS[• <br /> [rrfqrer� S+aTe S�eel ✓�trT<� Inr. PD, ��)n ISOd i rrefJ �s2od .2s'2•3)IN E✓•FR-6S-S3c�L�.S <br /> �`lUMl1i.CONIR�LIOR MK.ADORE55 Gltt ZIP PIIONE IILEuSE• <br /> �.i�sso� woim <br /> �- NEW ❑ ADDITION ❑ ALTERATION ❑ REPl,Ip ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOC.'�.710N <br /> JRl U��IU40!\'IOqN ICU51 O�AIAI[filA�y PLII$1R60R1 <br /> � �SOVD <br /> uFscniU� wouK / 1I <br /> P� inr y_�if�OnG1� /Ip.�l/� <br /> �isr or oun uuic <br /> I HEREBY CERTIFY THAT I Hr\VE READ AND EXAh11NED TI115 AP- <br /> �I'^� � PLICATIONANDKNOWTHESAMETOBETRUEAIiDCORRECT.ALI <br /> IlliAL0E5CRIV11pNOGPFOPER1Y15NUWN9fLOVlOR�ITNGNFOURCOPIES� pRJVISIONSOFLAWSAN�ORD�NANCESGOVEF;�lINGTHISTYPE <br /> OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIEU HERE• <br /> i oi_e�ac�—ov IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTfiER STATE OR LOCAL IAvJ REGULATING CONSTRUCTION <br /> OR THE PEnFORMA4CE OP CONSTRUCTION. <br /> SIGNATURE FCONiBACTORORAUi110R12EDAGENi D4IE <br /> X ��� � 6 �12 -86 <br /> ��nuJCC�n0�I1E55 �A RPPLICRN SCItYBU51NE55UCEN5EN0 j <br /> 3, � �- o� kes 1�� 3 — 3� — �.�-- <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTUflE FEE NO. TYPE OF EOUIPMENT FEE <br /> _ �WA7E�I�LOSET�701LEn __ AIRCOND. UNITS—HP.EA � <br /> ___ EiA1HT IB HEFRIGERA710N UNIiS—M.P. EA. _ __I �'- <br /> LAVATCRYIWASII BASIW OpI�EFlS—H P.EA. <br /> SIIOWEF' GAS FIflE�AC. UNIiS—TONNAGE EA I <br /> _. — �� _ J.__0�_ <br /> KIiCHEN SINK 8 DISR FORCEO AIR SYSTEMS-0?,ll. M EA. <br /> DISHWASHER WALLHEATERS—B.T.U. M <br /> LAUNDRY TRAV UNIT HEATERS—B.T.U. M <br /> CLO7HC5 WASHER EVAPORATWECOOLERS <br /> WA7Fq HEATER CLOTHESDRVERS <br /> 11RIN�L VENTIIATION FAN <br /> �RINKING FOUNTAIN RANGE FIOOD � <br /> FIOOR Df7AIN Alfi HAN�LING UNIT— flF.M. S <br /> VALUUM BREAKERS STOVE <br /> FOUF DFAINS—RAINLEADERS METAL FIREPLACE 8 CHIMNEV <br /> SINK�SERVICE—BAR ETC WOODSTOVE/FIREPLACE INSERT <br /> _— — `� )�/L 1 � —_ <br /> 7—` <br /> _ SUB TOTAL SUB TOTAL S LC� ___ <br /> _ PERMIT S PEflMIT S LJ _ <br /> TOTALFEE 5 TOTALFEE S � � <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> �NUNISEIp<CK flE�flSEIORCN SIOESEIBACN PUNCHEGNNUMOER PIANGUE(n[EE <br /> fEE nCCEiP1110 <br /> i151lUNI LOfAIIE♦ WCANi$IIE --- "�---- <br /> ❑VES ONO FEES VRIUATION _FEE _ <br /> ivPLO1CUN5f OCLUPnNCYGROpP NOOFOWEILINGUN175 <br /> I ___ BIIILDING f <br /> '.�lf pl 11�UU NO UI S�OPIES �AA1 OCG LORO <br /> PLUMBING <br /> MEGHANICAL <br /> I II7E SPRINKlERS REOUIRED L] YES ❑ NO <br /> OTHER <br /> PENALiY <br /> ePr�iltAiIONPCCOr PIANtiC11EGREpBY APPfiFORI55UNNCE�Y -- <br /> TOTAL <br />