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- o � G � Od � <br /> � ' r�PPLICATION fOh FEB 26 i��o � °°"e" <br /> '"'E"'"°'"° CONSTRUCTION °' � <br /> CItY OF <br /> evzrett PERMIT � cITY OF EVERETT � <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> TO BE COMPLETED IN INK - PLEASE PRINT P��blic Works Dept. <br /> ❑ DEMOLITION ❑ COM!JINATiON ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING �I�SIGN <br /> Qy���gp M�ILA�OPE55 CIIY ZIP PNONE <br /> /.'!G,. //'/�«i,cie._.<'y 3 Jl� - i�i t„" S ir��f � e7��/-"�-» �i�-�Gi <br /> ANCHrt[LIOROF.SICn[A M�ILAOOHESS � C�TY 2�P PHON[ <br /> GlNflPAL GONIRACIOR f� M�IL��U✓R�ESS pIV [ 21P VI�OHE LICEI1vE• <br /> A��/�%%l ���Y/(-':�- /�l�./�����./�.�� �:ll/�:�I�����`�� �{'F' , �f-����� -`�I�" 7G��� d-.�%ii� !`--r f i <br /> MEGUIIIf.4LCONiP�CTOfl M�iL��DNE55 CI1Y 21P PIIONE 4CENSE� <br /> PWMBINi1CO111R.1C10A MML�OORE55 CIiY 21P PIWNE UCENSE• <br /> cuss ov v�onr. <br /> ,�NEW ❑ l.DDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOC�TION <br /> ve�uaior�or wouK�cos*or'ran¢ma�s r�us�eaoni <br /> ."'v .-.�!"-,., �t.�. <br /> . .� '- <br /> oescnieewoan � , <br /> \ <br /> � Y ��' ! l�ZG 3�./.'�7/f.�� <br /> �'/-�Y/OI-L�/J' , �i �iU7 /1�_G%1i/,v.II/�7.J /[.:a1-� �-ti"Gi-v.-- C',U /(/C- - �'"� ' <br /> use or ouaou�o I HEREBY CERTIFY THAT I HAVE READ AND E?'AMINED TH�S AP• <br /> PLICATiON AND KNOV/THE SAME TO BE TRUE A VD CORRECT.ALL <br /> LEG�LDESCRIP11pNOFPROPER1Y15NOWN0ELOWON�ITACHFOUNCO�lES1 PROVISIONSOFLAWSANDORDINAN(,ESGUVE�NINGTHISTYPE <br /> OF WORK WILL BE COMPLETED WITh'WHETHEi' �- ECIFIED HERE- <br /> �o�—a�oc�—ov IN OR NOT.THE GRANTING OF A PERMIT DOER - 'f PRESUME TO <br /> GIVE AUTHOAITY TO VIOLATE OR CANCEL THE : ROVISIONS OF <br /> ANY OTHER STATE OR LOCAL lAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONS7RUCTION. . <br /> SIGNATURE O: CONipACTOR OP AUiN�RIZED AGENi DATE <br /> X '}.:'%T— / �%./:' <br /> PROJECI�OOOESS APPIIG�NPS CIiY BUSiHE55 L�ClNSE NC. <br /> ,3�Ci�-/lf,f 5,F'rr-> <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTUHE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET�101LET� A/C—A/HNOLG UNITS—�I.P. <br /> BATHiUO REFRIGERATION UNITS—H.P.EA. <br /> (.AVA70RY�WAoN BP.SIN� BOILEPS—B.T.LL/H.P. <br /> SHOWER GAS FI(7ED A�C.1M1T5—B.T.U. <br /> KITCHEN SINK 8 OISP FOFCED AIq SYSTEMS—BS.U. M EA. <br /> �ISHWASHER WALLHEATEPS—B.T.U. M <br /> LAUNDRYTRAY UNITMEATERS—B.T.U. M <br /> CLOTHE$WASHER EVAPORATIVE COOLERS <br /> UPINAL CLOTHESDRYERS <br /> DP�NKING FOUNTAIN �ENTILATION FAN <br /> FLOOR ORAIN AANGE HOOD <br /> �ACNFLOW PREVENTERS 'NATER HEATEP <br /> ROOF OFAINS—RAINIEADERS M�OOD SiOVE <br /> SINK�SERVICE—BAf7.ETCJ METAL FIREPLACE 8 CHIMNEV <br /> � FIfiEP1ACE INSERT <br /> NEAT PUMP <br /> GAS PIPING , <br /> E%HAUSTFAN <br /> SUBTOTAL 3 SUBTOTAL <br /> PEFMIT f PERMIT <br /> TOTAL FEE f TOTAL FE!� <br /> HIO�1�SF.�04CN R[AR 5'cIBACK SIDE SEiB�CN/' P�N CNECK NUMB[fl FEE RECEIPT NO. <br /> use zo��e � �ot nnEn �,��r��r y �- FEcS YALUATiON FEE <br /> �� OYES�O � <br /> BUILDING S <br /> rvPEOff.OH51 OCCUPAHGYGROUV NO.OFDWELLINGUNITS <br /> PLUMBING <br /> 51$E OF gyp� i�N NO Of$IOPIES MA%OCC.LOAD <br /> �� MECNANICAL <br /> N-' � <br /> OTHER <br /> FIRE SPRINKLERS REOUIRED ❑ YES O N.� STATE BUILDING Sl1RCHARGE <br /> STATEENERG'lSUFCHARGE <br /> 4VFlICt110vnCC 6t PIAflSGIECNEOBY A�PB FORISSURNCEBY <br /> PUBUCWORKS <br /> ���/ TOTAL <br /> � <br /> PROPERTY OWNERS ARE RESPONSIBLE FOfl L`fTERMINING ALL <br /> PROPERTV LINE LOCATIONS AND RELATED EASEMEhTS. <br />