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APPLICATIG] FOR COI�STRUC7 JN PERMIT ��'�'fe1 , <br /> me E�e�yree� TO BE COMPLETED IR� INK—PLEASE PRINT � � <br /> CITV OF <br /> everett HEATING SYSTEM: � GAS ❑ELECTRIC ❑ � <br /> � � BUILDING DEPARTMENT <br /> 259-8810 / <br /> G � � DEMOLITION COMBINATION BUILDING /MECHANICAL r,'�LUMBING SIGN <br /> �G y y OWNER I.IAILAD�RE55 CITV ZiP PMONE I <br /> � s ��rv� �i����l� l�£s� l9�``Au�S.E, �u�'-c.+1- '1ys-�3c,e� <br /> H H i[NANi MAiL ADDflE55 CITV 21P PHONE <br /> "x � �.�ivK uA�s-�R�M l0� 30 19 �N���- S�C. t=�,e� �YS-Z 3ck, <br /> ARCNITECTOFDESIGNEN M/ILADDiE55 CITV ZiP PHONE <br /> y��� �bA( Cc�lxntCe��� � Cc�LLSy �ucRa.�'1' RSZar 2S`Z I111 � <br /> 'j�' GENERALCONiqACTOR MAILAOORESS CITY 2iP PHONE LICENSE/ <br /> �o (°�r��4�n L�;���r,w�s Cs(��15 �,E,2�2 se.a� qBi55 �3s"-573) u�a3�Fz400�t <br /> OH MECHRNIGALCOMR�CTOR MAILAD�RE55 CiiY 21P PHONE LICENSE� <br /> p�g __Nb�� P���c.�-4eA�lrJ� (9o�o�E �Au.e,.rr�z u/+Y' n�C' SeA �18�sS�1oR.tN� �i���Ifs �'r <br /> � P�UMpiNGCONiRACiON 6URPpOBE55 CRV ZiP PNONE UCENSED <br /> � H 2�ueRS�De PLur�tr�iNU �135 /�/,�• �oKkC w�7 s� � 4E'�S�` R�verZs�.scd�+ <br /> y CLASSOFWORK <br /> �"'� � NEW ADDITION (IALTERATION ' REPAIR DEMOLITION WOODSTOVE/FRPL INSERT �. BUILDING RELOCATION <br /> y <br /> � y '�j C I I, In CONiALTJP�[R,SON�ND PHONE NO [� 7 <br /> CONTRAGTPRICEOFWORK �� J�.��O. �"`^�A��I��p� (��� ' 1 , lC � ' �uCC(?, � p�`� 7� / <br /> �� D[SCRiBE WOFK ANO 500ARE i00T�GE INVOLVE� �'(�Q � , <br /> �oy Ui-l�R� �lLs uMa� w�e� ��� �K�s�c� L�ni� HA6S��2b� <br /> — � -� PROPOSEOUSEOFOUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> ���� �,/��j APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> LEGALDESCRIPTIONOFPROPER7Y�SHOWN�ELOWORATTFCHFOIIRCOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WORK WIIL BE COMPLETED WITH WHETHEFi SPECIFIED�HEREIN OR <br /> �ot oi.ocK oc NOT. THE GRANTING OF A PEFMIT OOES NOT PRESUME TO GIVE ' <br /> � 1 /� �. AUTIIOFITY TO VIOLATE Ofl CANCEL THE PROVISIONS OF ANY � <br /> I��� � f�C9t OS OTHER STATE OR LOCAL LAW REGULATING GONSTRUCTION OR THE <br /> PEFFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATIOPJ IS MADE AND 1 COMP�Y WITH THE STATE <br /> CONTRACTORS LAW 18.27 qCW AND 296.200 WAf,. <br /> SIGNRIDREOFLONTRALTOflORRUTNOHRE�AGENT DATE <br /> S 9''' e. � E Eor - XC-a (����yl��� 7�1�90 ' <br /> PROJECTADDFESS <br /> pPPLiLqNi5GiY0U5i 5 I ENS N NOB11 MES A <br /> '�1 NLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> t�' WATER CV 15ET(TOILET) � NCrAIHNDL6 UNITS—H.P. <br /> BATHTUB FORCED AIR S`!STEMS—B.T.U. M E.A. <br /> ''�1 LAVATORY(WASH OASIN) UNIT HEATERS—B.T.U. M ; <br /> 1 ' SHOWER CLOTHES DRYERS ��— <br /> � KITCHEN SINK 8 DISP � � VENTILATION FAN <br /> DISHWASHER RANGE HOOD � <br /> 1 LAUNDRV TRAV WATER HEATER _ i <br /> ' CLO i HES WASHER WOOD STOVE I , <br /> URINhL METAL FIRE°LiCE 8 CHIMNEY <br /> �_ <br /> DRINKING FOIiNTAIN FIREPLACE INSERT <br /> ' FLOOR DRAIN HEAT PUMP i _ <br /> ' BACKFLOW PREVENTERS GAS PIPING _ <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> '� SINK(SERVICE—BAR,ETC.) _ <br /> �'� <br /> ' SUBTOTAL $ SUBTOTAL 3 'F� <br /> 1' ?EAMIT $ PERMIT 5 <br /> � TOTALFEE 5 TOTALFEE 5 <br /> FOR OFFICE USE ONLY: <br /> FFONTSETBACe RERliSEiBaCK SIDESETBACN PLANCMECKNl1M8[R FEE RECEiPiNO. <br /> USEZONE LOTAREA VAC/NTSITE FEES VALUATION FEE <br /> BUIL�ING <br /> IYPEO'GO���SALL01V.1BlE iYFE0FC4N5t.AtlUAI OCCuvu¢v NOormcnm�c�xrt5 <br /> caouv pWMBING <br /> a �co <br /> SIZEOFBLDG NOAFSTORIES 9ASEMENi 1AECHANICAL +- I5'PD <br /> OCCUPANCYIOAD FIR[SPqN¢lERSREOD HEIGNiLiM111iAT10N ADO:T�ONALPLANCHECK <br /> OTHER <br /> HEASON FOR 5^Ri W:ERS T <br /> STATE DUILDING SURCHnfiGE , <br /> INIAK[BY PLANS AVPROVEOOY CITY OF EVERE7T PUBLIC WOflNS <br /> . LOCALSALES � <br /> TAX CODE IS 3105 TOTA� ;�� <br />