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MsEverproen • �����CA��OI ! �� �\ everetl <br /> c�noF CONS'T�tUCTION � <br /> everett PERf1AIT <br /> BUILDING D[PAflTMENT <br /> 259-8745 TO BE COMPLETED IN INK - PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION !�-BUI�DING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> o�v� - �f�GUC`.'7 S� s��/j�es/C�� ln/ S�P. �L�(/��(%/ <r <'` auorie ` <br /> � iC JF.� / 3173/ l / <br /> �RCMREGIONLESIGNEfl MAILAOOPE55 q1Y ZIY PIION[ <br /> � i i i � i� ii /� ���e�nsh:il..�.//' <br /> GENEflAL CONTRAClOR IAAIL AOOFES$ C17Y 21P PIIOtIF LICEtlSE i <br /> �/ <br /> IA LMANILALCONTMCTOf� MAILAODRE55 CIIV 21P PIIONE IICEf!$[• <br /> PLl1MpW4CONTRAGTO(i MnILNDUHES✓ Cltt ZIP PIIDtIF tICOlSE• <br /> C,.U,{SS OF YIORN <br /> L 1 NEV� ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILD'.NG RELOCATION <br /> VA W RTION OF WOPH�LOSi OF IAAiEHIPLS PLUS I.R�ORI <br /> /OC7� (IC7d . <br /> OESCPiBE WORK � <br /> G�r,�(,_„T�r/ .�,»� � <br /> USEOFBUI�OING I HEREBY CERTIFY TI1AT I HAVE READ AND EXAMINED THIS AP• <br /> TL� �/ d< / y� PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL <br /> LEGALDESCPIPTIONOFPlIOPEFtY�5110WN0ElOWOPAITRGHFOURGOPIESI pROVI510NSOFLAWSANL'ORDINANCESGOVERNINGTHISTYPE <br /> s �v � �,t. `i� �y,% OF WORK WILL B�COMPLET[D WITH WHGTHER SPECIFIED HERE- <br /> �or l cioc�—or� � n IN OR NOl.THE GRANTING OFA PERMIT DOES NOT PqESUME TO <br /> GIVE AUTFIORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> �/nr'/< iJNO .!� �L?n '- � t� r �� ANYOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTION <br /> OR THE PEFlFORMANCE OF COtJSTqUCTION. <br /> ��( k ��c � � i-o�-n . , n �/- no �' SIGNATUflG OP CON7RACTGR Oli AUiHORIZLO A4[I!i D>TE <br /> X �t � ,� %-2 � - �P G <br /> PFOJECi AODFESS APPLICFN PS f.liY 0115�1![55lICCNSE NO <br /> /2D� 1 /4<,c� Z�. S. � <br /> PLUMBING MECNANICAL <br /> NO. TVPE OF FI%TUflE FEE NO. TYPE OF EOUIPMENT FEE <br /> Z WATER CLOSET�TOILET) C`� O AIR COND. UNITS—H.P.EA. <br /> � BAThTUB J C.Z) REFRIG[RATION 11NITS—H.P.EA. <br /> 2 LAVATORYIWASH BASIW � L ❑OILEflS—HP.EA. <br /> �_'—__ <br /> � SHOWER C') GAS FIRED A.C. UNITS—TONNAGE EA. � (�� <br /> � KITCHEN SINK 8 OISP. � FOflCED AIfl SYSTEh1S—BS.U. M EA <br /> I DISHWpSF1ER � Q� NALLHEATERS—B.T.U. M <br /> LAUN�RYTRAY 1NITHEATERS—BT.U. M <br /> CLOTMES WASdER S IEX� EVAPORATWB COOLERS <br /> � WAiEfl'HEATER-' CLOTH[5 UflYERS <br /> URINAL � VENTILATION FAN C�+ � <br /> ORINKING FOUNTAIN RANGE HO00 <br /> FLOOR DRAIN Alfl HANOLING UNIT— CF.M. <br /> VACUUAIOREAKERS STOV[ <br /> ROOF�RAINS—RAINLEADERS METAL FIREPLACE 8 CHIMNEY <br /> SINK�SERVICE—BAR.ETC.1 WOODSTOVE/�FIR��E�PLrACEINSERT <br /> — `��1Ncx-iPa C� s75 <br /> SU0 TOiAL . � SUD TOl'AL S 2� C/� <br /> PEflMIT S PEflM1T S <br /> TOTAL FEE S TOTAL FEE S �� �� <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> FROIrt SETBACN REAR SETBACK SIDE SETOACN PLAN CIIECK NlIM110[R �IAN CIIELK FEE <br /> \ `` -1 � � / l /�(� <br /> �r�tl H'[�1 � (7(_ / ��oC.d � FEE ��S (,ylkr �ECE�Pt N0 O� I� j�J <br /> USEZOHE �OtAfi[A a � D ✓ <br /> __ — 1 VACANi51TE — FEES YAWATICN FEE <br /> r� `IUO s� �E5 ���o <br /> —_--�- � <br /> TVPEOFCO�lST OLCOP(A]NGYGROUP NOOFOWELIINGUNITS �(/r) <br /> U^/�� IL � � � BUILOING SL��'7CGt�-� �.(�J I � <br /> 512E OF pIOQ NO OF SiORIES MA%OLC LOAD � <br /> '/ /�LI L Lf/ � 1 PLUhIpING �S U <br /> lDV l r" la <br /> MECHANICAL � � <br /> FIRE SPRINKLERS HEOUIRED ❑YES CI NO (� <br /> OTHER r`�� 1��� <br /> FENALTV <br /> APPI.IGATIONACCOY PLANSp�ECNEDBY APPPFORISSUANLEBY <br /> TOTAL � �� �� G�� <br /> �,n.v� � ;: r� G .C. <br />