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� /� <br /> � ��._.,PPLICM�I�N � ���,' everetl . <br /> ,�, �TMO��n CONSTRUCTION � <br /> � everett PERMIT � <br /> BUILDING DEPARTMENT <br /> i 259-8745 TO BE COMPLETED IN INK- PLEASE PRiNT <br /> ❑ DEMOLITION ❑ CUM8INATION ❑ BUILDING ❑ MECHP.NICAL ❑ PLUMBING ❑ SIGN <br /> M41Lh00RE5S CITV � ZIP P��UNE <br /> � � � � �, � � ' �. � q�s� .7_ C�Z �i 5?Fs7 <br /> OWN <br /> rau�c�' G. �>ilu'�riv Z1ZOL�` (6'yi����.c' /�lt ��i�ai�.�cce:� /.-t,� , h. , _ <br /> �RCHITECiOR0E51GNER MARAODRE55 C�TY 2iP PHONE <br /> - GENER�L WNTRACTOR MAIL ADOliE55 GIIY ZIP P��ONE L:CENSE• <br /> MECMRNIC4LGONTRACTOfl MRILADORE55 Cltt ZIP PNONE LICENSE• <br /> ' PLl1MNINGCOMlVRGiO� MAII�D�f1ESS UTY ZIP PHONE IICENSE� <br /> CLASS OF Y/ORN <br /> � � NEW ❑ ADDRION ALTERA710N ❑ REPAIR ❑ D[MOLITION ❑ WOODSfOVE/FRPL.INSERT ❑ BUILDING RELOCA710N <br /> . veWnnorvorwonH�costorn+ �usi.noom �. <br /> � L 'l� /��� <br /> � oescniee won� � n � _� <br /> i• �i 1.�'�� ,• <br /> i '/ <br /> i useo uaoiu I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> PLICATION AND KNOW THE SAME TO BETRUE ANDCORRECT.ALL <br /> LEGRLOESCPIPiIONOFPl10FERiVISNOWN�[LOWOIIAiTPCHFOUlICOPIE51 PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> � z/ OF WORK WILL BE COPAPLETED'NITH WHETHER SPECIFIGD HERE• <br /> �� �or�e�ocr�—or ��" — L��'� �N OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> � GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> ' OR THE PERFORbIANCE OF CONSTRUCTION. <br /> ,� � � J 1 SIGNATUPE OF CONiRl.CTOi7 OR AUTHORIZED AGENT O�TE <br /> � X I r � / 7 ��-' �/ � � GS 7 <br /> ,r,c�� .��> <br /> PFOJECTAOORESS APPLICANiSCIlY9U51NEi5LICEN Jb <br /> �O <'J�� ��1 ! /i /�i � l� . <br /> PLUMBING _ MECNANICAL __ _ <br /> � NO. TYPE OF FIXTURE FEE NO. TfPE OF EQUIPMENT FEE <br /> , ' WATEHC.OSET(iOILED AIR WND. UNI-S—H.P.EA. <br /> �i ' � M PEFRIGERATIOIJ UNITS—H.P.EA. ' <br /> � �� 2/�� BATHTUB Q SG�!_ —. — <br /> : � LAVATOFVIK'ASH BASIN) S � DOILEPS—H.P.i_A _ <br /> . • SHOWER �D'hC'17RIT9=TBroNM''E'ER •���� <br /> � KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS—B.T.U. M EA. 'J �k''� <br /> � � DISHWASHER WALL NEATERS—B.7.U. M . � <br /> � LAUNDRYTRAV UN1IHEATERS—B.T.U. M _ <br /> CLOTHES WASHEfl S OO EVAPORAiIVE COULERS <br /> WATER HEATER CLOTHES DRYERS � <br /> � UP�':FL VENTILAiION FAN � <br /> � DNWKINGFOUNTAIN f7ANGENOOD <br /> FLOOA DRAIN Alfl HANOLING UNIT— C.F.A1. _ , <br /> � VACUUM BREAKERS STOVE <br /> ROOF f IAINS—RAINLEADERS IdETAL FIR[PLACE 8 CHI1dNEY <br /> � SINK�SERVICE—BAR ETC.) _ WOODSTGVE/FIREPLACEINSERT <br /> i. <br /> i <br /> � 1 <br /> d <br /> SUBTOTAL SUBTOTAL 5 <br /> PERM:T S PEflM1T 5 <br /> 'a TOTAL FEE S .� TOTAL FEE 5 <br />' � THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> �' � FRONt SEiOACN REAR SEI��CM SIOE SEIBAGN PLAN CII[G N�UM]�dE(i� PLRN CMECN FE[ (�,. <br /> �'� �� � � ��^� ( W"� PEE���O I RECEIPi NO. ll L J`Y V <br /> 1 .� !..) � i� <br /> '� USE20NE �/� LOTAFEA ypCANISIiE <br /> } /.� � ' / ) J'7 � ES ONO FEES VALOATIUN FEE ___ <br />�'I « / 1 <br /> ttPEOFCONST. OCCUPANCYGROUP NO.OFDWELLINGUNIiS <br /> ' BUILDING E� y �. <br /> I � SIZE 0�OG. NO.OF SiOR�S MA%ACQ IOAD <br /> D C PLUAIBING <br /> I <br />. � MECHANICAL <br /> i <br /> '� FIRE SPflINKLERS RGQUIRED ❑ YES ❑ NO q� � <br /> OTMER ;�� S �7b <br /> i <br /> � PENALTY � . (�J C� <br /> RPPLIC�iION�LC.BY 'i'�RN$CIIECNED 6Y APPR FOii ISSUANC[BV <br /> TO(AL <br /> h�/. -�'•� � •� . ; <br /> ,. <br /> , . _. . . . _ ,.: ._ .. , .. _ . <br /> _ . ... <br /> -�--�.. . _.. � __ . . �_. . .. _ � <br />