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�-.�'PLIICATION FOI. ��� <br /> ,".E"'°'"" CONSTRUCTION O <br /> c�n of <br /> everett PE�MIT <br /> BUILDING DEPARTMENT <br /> 259•8745 TO BE COMPLETED IN INK- FLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION O BUILDING ❑ MECHANICAL � PLUMBING ❑ SIGN <br /> Ow��EA . <br /> M�II��ORL39 CIIV / .� �-, VIIUHE � �,C r(.;f1 i <br /> � �rJy � f ! i� f I /'Jl J1-J/ . f� // "•%°' � '•' • ` ,���=�-- <br /> � MML�D�RE9S GIiY L U E <br /> •RCNrtEW OA�ESiO��ER <br /> OENER�L LONIR�CtOR Mul�ODPESS CIiV ZIP 1 PnONE LICENSE• <br /> > .: 1� . � <br /> i'� G. i'/L!. J 1� .' .`/( �` t �l � c_i' t <br /> '� C_` ��l � J - r��oNe ucer�sr <br /> MECN�NICILGONIP�CTOfl MML�DORE95 CIfY ZIP <br /> PLUMBINO CONIR�CTOA <br /> MRIl�O�RESS CIfV ZIP P��ONE LICENSE� <br /> CL�SS O�WORK <br /> ❑ NEW ❑ ADDITION ❑ ALTERAiIUN ❑ AEPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING fiEIOC�TlO�!_ <br /> VAIU�iIONOfWOPNICC1510f1.la .NqLSPWSLeBOR1 �'..._ .-- "--. -. .. --. . . . — '�♦� �J ,- • <br /> �C`-+ y F- � �( ��r d��� i r! 1��>T�:��il � / S,�'C� <br /> DESC(LBE WORK 7 <br /> � ! �I ; 7 - � � i ., - C.7 /'/ -) � - <br /> uscorew�ou+o I HEREOY CERTIFV THAT 1 HAVE READ AND EXAMINED THIS AP- <br /> P.��� f �U12��^,� PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECi.ALL <br /> LEOKOESW�YIiO��OFPf10PL(i�V1+��OWNOELOWO�A1LC11FOORf.OPIE51 pqOVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVFE <br /> OF WORK WILL BECOMPLETED WITH WHETHEfi SPECIFIED HERE• <br /> �p�__eLOCK�aF IN OR NOT.THE QRANTINO OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANV OTHER STAiE GR LOCAL LAW RE6ULATING CONSTRUCTION. <br /> OR THE PERFORMANCE OF CONSTRUCTIGN. , . •�_ ` <br /> SI�NATURE OF CONIPACTOR OF AUTHORIZED AGENT �47E �� ^ � <br /> X � <br /> L �;�-,:��-. �� <br /> •PPL�GANiS CIfY BUSINESS LICENSE NJ. � <br /> VPOJECT�D7RE55 <br /> � ��c��J ��� {�+' ��i ��G _ <br /> PLUMBINO _ __ MECHANICAL � <br /> NO. TYVE OF FI%TURE �cE NO. TYPE OF EOUIPMENT 'EE <br /> WqTER CLOSET ITOILEn AIR COND.UY�TS-H.P.EA. _ <br /> BATHTUB REFRIGERA�ION UNITS-H.P.EA. _ _ _. <br /> LAVATOFYIWASH BASIW BOILERS-H.P.EA _ __.- <br /> SNOWEF GAS FIRED AC. UNITS-TONNAGE EA. , _ <br /> KITCMEN SINK 8 DISP. FOFCED AIR S�SiEMS-B.T.U. M EA. _ <br /> �ISHWASHER WALL HEATERS-B.T.U. M _ _____ _. <br /> LAUNURYTRAY _ UNR HEATERS-8].U. M _ <br /> CLOTHES WFSMER EVAPORATIVE COOLERS —� <br /> WATER HEATER CLOTHES DRYERS _ _ _-_ — <br /> -- VENTILATION FAN <br /> URINAL <br /> �RINKINO FOUNTAIN RANGE HOOD _ -- - <br /> FLOOR DPAIN AIR HANDLIN�UNIT- C.CM. _ .. <br /> VACUUM 9REAKERS _ SiOVE _,_ - --- - - <br /> ROOF DRAINS-RAINLEADEflS METAL FIREPL: :E L 9HIMNE`/ <br /> SINK�SERVICE-BAR ETC.) WOD�STOVElFIREfLf�CEMSERT _ __ <br /> SUBTOTAL SUBTOTRL _ � __ _ <br /> PERMIT f PEFMIT s --.� <br /> TO7ALFEE 2 TOTALFEE f _ , <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> PUNCPfIChfEE --- <br /> fF6NI5E1B�CK ��L4RSEI�TCR S�OESEIBRCN PlANC11EC NUMBER ._�, <br /> �l� � I i . �� . I �'] I ��l ree��'l . - nccemr u�` !/.'n <br /> i <br /> c7� JG. <br /> USE 20�� , LOI�PE� VnCA�II SrtE FEES VtLWTION FEE <br /> ��._ ` : .�. ❑vE5.�1N0 <br /> / <br /> TYPEOFCON51 OCCU�4NCYGIIOUP NODFLWF:LUtIGUNItS J�/��,ry p� i__-_.._ _ -- <br /> � � � �x- _� BUILDING 5�'�V V• J�_V� <br /> S4E O�BIDG` ��O U� SIO�iES M�%OCC 10�0 <br /> � t ,� PLUMBING <br /> ,f 50 1 ,., - -- <br /> �y���. ��� l�� )� �p•�J MECkANICAL __ <br /> FIRE SPRINKLERS REOUIR[D ❑ VES NO pTHFn <br /> rer+n�rr <br /> avruuuonecr, ev ��i�i+sc�¢eKeoov APPN (O�ISSURNG[OY <br /> TOTAL <br /> �a-� L � . Soum To F�E �r,a,�us�• <br /> - '�{ 1F1P�Y°�� oa-',vQe . <br /> J <br />