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'..-�PPLICATION F4�� evcrelt <br /> '°.E",°`"" COy N S7'R U CT 1 O IV � <br /> LITY OF <br /> everett PERA�IT <br /> BUILDING DEPARTMENT <br /> 259-8745 TO BE CC)MPIET€D IN INK• PLEASE PRINT <br /> ❑ DEMOLI71r,N ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING O SIGN <br /> OWNEII M�II RO�NESS CITV 21P FNONE <br /> -Ni� /� ee;nf� tin��.�,✓ a�o3 s�ti sr: �ve�e.�f- isao � a �a - � �a� <br /> ARCNI�E(. OROESIGNER MAIL�ODPESS CITY ZIP FHONE <br />� GENER�LGONIR�CIOR MAILB�ONE55 CitV ZIP PMOHE LICENSE• <br /> MLCnANJ4lCONiRACtOq MAILAOORE55 .CiTY ZIP PIIONE ULENti[• <br /> PWMBMGCONIf1�GI0R IdMLA0pRE55 CI1Y ZIP PIIONE IiCENSE• <br /> CLASS OF WORN <br /> ❑ NEW ❑ ADDITION ❑ ALitRATION ❑ REPAIR ❑ DEMOLITION �I WOODSTOVE/fRPL.INSERi ❑ BUILDING RELOCAIION <br /> VALU�IION Oi WORKIWSi Of MAIERIPLS PWS LABOR� <br /> g�n �O <br /> 6ESCfViOE WONN <br /> . li� 'y O U /7 CL /� Y �"l� ' / i ' /C�t <br /> use o�euaou+c <br /> I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINFD TIiIS AP• <br /> / P� PUCATIONANDKNOWTHESAMETOBETRUEANDCO�RECT.ALL <br /> IEG�L0E5CflIP11UNOFPqOFENfY�SNOWN0EL0 OR�tiRGNFOORGOPIE51 pROVISION50FLAWSANDORDINANCE530VERNINGTHISTYPE <br /> OF WORK WILL BE COMPLETED WITH WHETNER SPECIFIED HERE• <br /> ior—e�ocK—oF IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOI�TE OR CANCEL THE PROVISIONS OF <br />� ANVOTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSiRUCT10N. <br /> SIGNATURE OF CONiRFCiOR OR AUTHOR2E0 AGENi �AIE <br /> X 9 <br /> cr � �c�� /a , . <br /> VBOJECi PODPESS PLICANTS LRY BUSWE55 UCENSE NO <br /> � 70 3 ��l�, s�- E c�r,c�zY� <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FI%TURE FEE N0. TYPE OF EOUIPMENT FEE <br /> WATEq CLOSET�TOILET) AIR COND. UNITS—H.P.EA. <br /> BATHTUB REFRIGERATION UNITS—H.P.EA. <br /> LAVATORYIWASH BASIN� BOILERS—H.P.EA. <br /> SHOWEf7 GAS FIREO A.C. UNITS—TONNAGE El�. <br /> KIiCHEN SINK E DISP. FORCED AIR SVSiEMS—B.T.U. M EA. <br /> OISHWASHER WALLHEATERS-81.U. M <br /> LAUNDFiY TRAY UNIT HEATERS—B.TL. M <br /> CLOTHES WASHER EVAPORATIVECOOLERS <br /> WATE(7 HEATER CLOTNES�f7YER5 <br /> URINAL VENiILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DPM1IN AIR NANOLING UNIT— C.F.h1. <br /> VACUU1dBREAKERS STOVE <br /> ROOF OPAINS—RAINLEAUERS METAL FIREPLACEB CHI1dNEV <br /> SIIIN�SERVICE—BAR,ETC.) �4'OODSTOVE/FIREPLACE INSERi <br /> SUDTOTAL SUBTOTAL f <br /> PERMIT S PEHMIT S <br /> TOTALFEE 3 TOTALFEE f <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> �NONt5EI0ACN 11ERRSEfUACK SIOESEtF1ALK PlANC1�EGNNUMOER PLRNCI�[CrcfEE <br /> FEk nECEIPi NO <br /> ❑$C20NE LOfAitEA VRCANi51IE <br /> FEES VALUATION iEE <br /> OYES ONO <br /> tYPEOfLONST OCCUPANCYGROUP NOOFpWEL4NGl1N115 <br /> BUILOING E <br /> :vr or mna NU ai •{��II�If.9 M�% UCG IUAU -------- "—"-----� ---"-'"---" "�— <br /> PLUh101NG <br /> 1dECHANICAL <br /> FIR[ SPRINKLERS REOUIREO ❑ YES ❑ NO � <br /> OTMER <br /> PENALTY <br /> AI'PIICAi'ONACCBY PL�NSCNECNEOBY AFPqFORI55l1AHCEBY -- <br /> TOTAL <br />