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��.Ew�o,..� . .PPLICATION FO,�, <br /> CITYOF COM1lSTRUCTION everetl <br /> everett pE�M�� � <br /> BUILDING DEPARTMENT <br /> 259•8745 'f0 BE COMPLETED iN INK- PLEASE PRINT <br /> ❑DEMOLITION O COMBINP,TION ❑ BUILDING <br /> ❑ MECHANSCAL ❑ PLUMBING ❑SIGN <br /> OWNER �/1 /�/y�,, �M!�1IJ RDOfi[SS <br /> C ""� �t�i iS � � �QQC�K{�C'/q�� Cit� 21P PHONE <br /> ARCIIIfECipRDE�IER M�iL�ppR���•� �� —� ���� "" " _/ �4 �� � �5.� � <br /> Cry ZP �IONE <br /> OEHERaICON�PAC�Oli <br /> 5/� �/] /yM/�AI.L�FO(U�fiESS ��ry —� <br /> 1.1���(.�`C. aS LC �U{� ZIP PII1OJN'E� �ICENSE� <br /> MEf.HANIC�L LONIpACT01� IAeIL�000 iSS----'--�_.._I�F\l� ��J/. � D I� O �� / <br /> CIIY TN PIIONE <br /> LICENSE• <br /> PIUMBIY..CONiP�CiOR IAMLAD[IqE55 '--'— <br /> CIIY 21P <br /> PiIpHE IiCENSE• <br /> ��S$OF WOAN -- <br /> NEW ❑ ADDI710N ❑ ALTERATION ❑ R,:pqIR ❑ DLM�LITION ❑ WOODSTOVE/FRPL.14SEfiT ❑ <br />" LU�IIONOi WpqN�C091 OF Mp[qI�L9 PW9 UBOR� BUILOING RELOCATION <br /> 5��t�� — <br /> ESCPiBE WOPN -�-- <br /> �.c c��� Q y��. --- <br /> , <br /> SEOiBUILUING �'� p _ Qp�� n ���7-� <br /> ���'"�� ' �" "'��"��'�0� /�'�" �� I HEREBY CERTIFY THAT I yAVE READ AND EXAMINED THIS AP• <br /> ae�oesen�pupqpFPROPENIY(SIIOWNOELOWONRiTPq F URC! ies PUCATIONqNDKNOWTHESqMETOBE7RUEANDCORRECT.ALL <br /> �-j�r�� 7�� \ PROVISIONSOFLqWSANDORDINANCESGOVERNINGTHISTYpE <br /> _eioc�_or C_, OFWORK. NILLBECOMPLETEDWITHWHETHERSPECIFIE�HERE• <br /> IN OR NOT. TIiE GRANTIIJG OF A PERMITDOES NOT PRESUME TO <br /> GIVE AUTHJR!f Y TU VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANYOTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMAPICE OF�CUNSTRUCTION. � <br /> � SIGNqTURE OF CONiRACiCP Ofi AUiNOflIZED AGENT DATE <br /> L- — — �� - 5' X `�-�--S. " � <br /> o�ecreoon¢ss <br /> 2 // �-- APPLICANISGiYBU51AE554CEN5E <br /> / " ,.� ! <br /> UMBINO <br /> p, __ MECHqNICAL <br /> TVPE OF FI%TUflE �� N� � - <br /> WATER CLOSET�TOILET) T�'PE OF EpUIPMENT FEE <br /> BATMTUB FIR COND. UNI�S-H.P.EA. <br /> LAVATORY�WASH BASIN� �-'v REFR:GEqA110N UNI75-H.P. EA. <br /> SHOWER � BMLE95-H.P, Eq. ---� ', <br /> KITCHEN SINK 8 OISP. � UU GAS FIqEO AC. UYITS-TONNA�E E0. — '� <br /> — J <br /> DISHWASHER � C� FOPCEO AIR SYSTEMS-B.T.U. M EA . <br /> LAUNDRYTRAY --S WA�LHEATER�-BTU M ' <br /> CLOTHESWASHER UNITHEATERS-B.i.U. M ' <br /> WATER HFATER ' � E`/�PORATIVE COOLERS <br /> URINAL — CLOTHES DRVERS SJ � <br /> �f11NKING FOUNTAIN - VENTILATION FAN — �� <br /> FLOOR DRAIN — RRNGE HOOD � � <br /> VACUUM BREAKERS — AIR HANOLING UNIT- QF.AI. <br /> ROOFDRAINS-RqINLEADERS — , STOVE - <br /> SINK�SERVICE-BAR ETC� —' — METAL FIqEPLACE d CHIMNEY ' ' <br /> ! _ WOODSTOVE/FIREPLACEINSERi <br /> _ L(l/ -- _ " ' ��,,� `JZ) . <br /> �_ <br /> SUB TOTAL n� - <br /> ... PEpM1T s — SUB TUTAL __ S <br /> TOTALFEE s -- �ENMIT s — <br /> TOTALFEE s <br /> THIS PORTIOIJ Tt} BE COMPLETED BY BUILDING OEPT. PERSONNEL <br /> SEfg.1C� NEA115[IOnCN SIOE SEiOnCK <br /> 'UN CHECN NUAIpER <br /> � , � �J � � �{ PL4NCHECKPEE <br /> NE lO1RN[A � (_�� `CL7C 4 / 1L..� RELS��Jy�� / . <br /> � V qNtSiIE Jl���� <br /> YES 1]ND FEES VqLUATION FEE <br /> FCONSt OCCUPANCVGNOOP NO.OPDW[���NGUNItS � <br /> ��1 r ' �3 I <br /> F BLOG NO O!SIOAIES M4;.OCG LOAO BUILDING �_� � <br /> i�. �. �-Ibf� ° 5�cxc� - <br /> r�un�oiNu / <br /> (fi� � <br /> SPRINKLERS qEOUIRED LI 1'ES ❑ NO MECHANICq� � <br /> e <br /> OTHER ��U X... /' �-� �� <br /> V <br /> AiION pLC 6V P�AryS CIIECkED BV APPq.�OR ISSUPNGE BY PENA�T� � � <br /> �v- �1 <br /> G .o..� � <br /> �� `__� G . �° � ,.. <br /> �����---�_�=. ' <br /> �-. . _ <br /> �`�.c, vw- <br />