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. .PPLICATION FO.. ���,�„ <br /> '"'E""°'"" CC�NSTRUCTION 0 <br /> CItY OF <br /> everett PERMIT <br /> BUILOING DEPARTMEN7 <br /> 259-8745 TO BE COMPLETED IN INK- PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNER MAI�� �RE55 CIiY ZIP CIIONE <br /> 1 ofZ3 �fl��V/I A:t-a.k, •� �, 2 z 5 �3� �u�— �>. L�- <br /> ♦PCHIIEyi pRDESiONEP I�GiLAD�PE55 � CItY HP �nUNE 'G' , �SG;� � <br /> ll� �,ll, /Lk'r)a. � /���57/�' r'is- r,ff sT /<ic:.�['/Jsc� l�/i 6-;z/zcv <br /> OENER�ICONfR�GIOR M��ODf1E55 CIT' ZIP PHONE LICE�lSE <br /> MECH�NIC�L CONtR�CIOH MAR�DDRESS GRV IIP PIIONE IICENSf• �I <br /> I <br /> VLUMBIN�CONIR�CIO'1 MAILAOOHE49 CIIY IiP PI�ONE L�Cf11S[ • II <br /> CLAS f WOPN <br /> NEW ❑ ADDITI01! ❑ ALiERAtION ❑ FEPAIR ❑ DEMOLIfION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING �ELOC�TION <br /> V�LU�IION OF WOFN IG051 O�IAn�ERIA1.5 PWS LRBORI <br /> �i s i��� <br /> DESCRIBE WORK � <br /> � -v S �' Gt. <br /> useareun.ou+a I HEREBY CERTIFY iNAT I HAVE REI1D AND EXAAIINED THIS AF� <br /> PLICATION AND KNOW THE SAME TO F3E TRUE ANDCORRECT.ALL <br /> LEO�LUESCRIPIIONOiPROPEP�YISHOWHpELOWOR�iT�CNFOURCOPIE51 PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br /> ior�e�oc�—or_ IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PHESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PAOVISIONS OF <br /> ANV O7HER STATE OR LOCAL LAW REGULATING CONS7fiUC'rION <br /> OR THE PERFORMAMCE OF CO RUCTION. <br /> SIQNATURE OF CONtRRCiOR AUTHO �IED AQENT �ATE <br /> "Y / /GG(!(�i , tt.c r7, -445'� _ <br /> PPOJECT�DDPE55 A LI ANI'SGItYBU5iNE55lICEN5EN0 <br /> // Z 2 qf� /j� S. C-= <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FI%TUAE FEE NO. TYPE OF EOUIPMENT FEEr _ <br /> WATER CLOSET(TOIIEI) AIR COND. UNITS–H.P.EA. I <br /> BATHTUB REFRIGERAT�ON UNI15–H.P.EA. � <br /> LAVATORV(WASH BASIN� OGILERS–H.P.EA. __�_ <br /> SHOWER OAS FIRED AC.UNIiS–TO�NAGE EA. __ _ <br /> KITCHEN SINK 8 OISP. FORCED AIR SVSTEMS–B.T.U. M EA __ <br /> DISNWASHER WALL HEATERS–B.T.U. M __ __ <br /> LAUN�RY TRAV UNIT HEAiERS–B.T.U. M _ <br /> CLOTHES WASHER EVAPORAiIVECOOLERS <br /> WATER HEATER CLOTHES DRYERS _ <br /> URINAL VENTILATION FAN <br /> ORINKING FOUNiAIN _ RANGE 11000 <br /> FLOOR ORAIN AIR HANDLING UNI7– QF.M. ___ __ <br /> yp�UUM BREAKERS SiOVE _ <br /> AOOFORAINS–RAINLEADERS METALFIREPLALEB CHIMNEY _ <br /> SINKISERVICc–BAR,ETC.1 WOO�STOVE/FIREPLACEINSERT __ <br /> SUB TO7AL SUB TOTAL �! - 1 I <br /> PERMIT f PEHMIT f <br /> 70TALFEE ! TOTALFEE • . _ Ii <br /> TNIS PORTION '�O BE COMPLETED BY BUILDING DEPI'. PERSONNEL i <br /> fRONBEfO�CN �[<p5E18�GN SIOESF.TB�CK �IANCMECNNUMOEH i`L�NC��ECnfEE <br /> GEE RECEiPI NO <br /> USE ZONE LOI ROFA ypCr�Nf$IIE <br /> FEE9 VAWBTION F[E <br /> ❑YES ONO <br /> tVPEOF(;ON51 OCCIIPnNCYGROUP NOOFpWF.ILINOUNIiS <br /> BUILDING S :/ ( �� ��(,1 <br /> Si:E Of BIOG ❑p OV S�ORIES MA%.OGC LO�D � �` � � <br /> PW MB�NG <br /> MECHANICAL <br /> FIRE SPi71NKLERS REOUIREO ❑ YES ❑ NO <br /> ' OTHER <br /> PENALTY <br /> APPIICAI�p�lAC: UV �'L��1iC11ECNE00Y APPII (O�ISSU�NGEBY — . <br /> J i' TOTAL �` �,I�.'1 <br /> <) <br /> 1�,�.—� �ru�.! �� �� t��z.����. <br /> . ` ��,�ti.� 'f��I��T'Y <br />